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. 2023 Jul 7;12(13):4540.
doi: 10.3390/jcm12134540.

Lymphatic Complications Following Sentinel Node Biopsy or Pelvic Lymphadenectomy for Endometrial Cancer

Shinichi Terada  1 , Tomohito Tanaka  1   2 , Hikaru Murakami  1 , Hiromitsu Tsuchihashi  1 , Akihiko Toji  1 , Atsushi Daimon  1 , Shunsuke Miyamoto  1   2 , Ruri Nishie  1 , Shoko Ueda  1 , Sousuke Hashida  1 , Natsuko Morita  1 , Hiroshi Maruoka  1 , Hiromi Konishi  1 , Yuhei Kogata  1 , Kohei Taniguchi  2 , Kazumasa Komura  2 , Masahide Ohmichi  1
Affiliations

Lymphatic Complications Following Sentinel Node Biopsy or Pelvic Lymphadenectomy for Endometrial Cancer

Shinichi Terada et al. J Clin Med. .

Abstract

Sentinel node biopsy (SNB) is performed worldwide in patients with endometrial cancer (EC). The aim of this study was to evaluate and compare the occurrence rate of lymphatic complications between SNB and pelvic lymphadenectomy (LND) for EC. The medical records of women who underwent SNB or pelvic LND for EC between September 2012 and April 2022 were assessed. A total of 388 patients were enrolled in the current study. Among them, 201 patients underwent SNB and 187 patients underwent pelvic LND. The occurrence rates of lower-extremity lymphedema (LEL) and pelvic lymphocele (PL) were compared between the patients who underwent SNB and those who underwent pelvic LND. The SNB group had a significantly lower occurrence rate of lower-extremity LEL than the pelvic LND group (2.0% vs. 21.3%, p < 0.01). There were no patients who had PL in the SNB group; however, 4 (2.1%) patients in the pelvic LND group had PL. The occurrence rates of lower-extremity LEL and PL were significantly lower in patients who underwent SNB than those who underwent pelvic LND. SNB for EC has a lower risk of lymphatic complications compared to systemic LND.

Keywords: endometrial cancer; lower-extremity lymphedema; sentinel lymph node.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Chart of the study participants who underwent sentinel node biopsy (SNB) or lymphadenectomy (LND). A total of 407 patients met the study criteria. Among the 407 patients, the correct records were unavailable from the medical records in 4 patients, 1 had a synchronous malignant tumor, 4 died, 5 had lower-extremity edema for obviously different reasons, and unilateral sentinel node mapping failed in 5 patients. Therefore, 388 patients were included in the study.
Figure 2
Figure 2
Kaplan–Meier curves of the rate of lymphedema in the sentinel node biopsy (SNB) and lymphadenectomy (LND) groups. The cumulative incidence rates of lower-extremity lymphedema (LEL) in the SNB group at 1 and 3 years were 1.5% and 2.0%, respectively. In the LND group, LEL occurred at 1 and 3 years was 7.0% and 16.0%, respectively.
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