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The following is a summary of “Patient-reported lymphedema after sentinel lymph node mapping in women with low-grade endometrial cancer,” published in the March 2025 issue of American Journal of Obstetrics & Gynecology by Bjørnholt et al. 

Sentinel lymph node mapping enabled the detection of metastases while reducing radical lymphadenectomy risks in low-grade endometrial cancer, though its impact on lymphedema and quality of life (QoL) remained unclear.  

Researchers conducted a retrospective study to analyze the risk of patient-reported lymphedema after sentinel lymph node mapping in low-grade endometrial cancer and evaluated risk factors and condition-specific QoL 12 months post-surgery.  

They included women with presumed stage I low-grade endometrial cancer on sentinel lymph node mapping (March 2017–February 2022). Validated patient-reported outcome measures were collected before surgery and at 3 and 12 months postoperatively. The primary outcome was the leg lymphedema domain score from the European Organisation for Research and Treatment of Cancer-Endometrial Cancer Module (EORTC QLQ-EN24). Lymphedema assessment had 7 validated single items from the EORTC QLQ-EN24 item library, addressing lymphedema in the legs, genitals, and groin. Disease-specific QoL was estimated by the Lymphedema QoL Tool, with scores transformed linearly (0–100). A change of 8 points in leg lymphedema sum-score was considered clinically significant. Mean difference scores over time with 95% CI were estimated. Multiple linear regression models identified baseline predictors for 12-month postoperative lymphedema scores and assessed whether early lymphedema predicted lymphedema at 12 months, Condition-specific QoL was evaluated for those with lymphedema.  

The results showed 79% (486/617) completed patient-reported outcome measures at baseline and 12 months. The mean difference in leg lymphedema score from baseline to 12 months was 5.0 (CI [3.3, 6.8]), remaining below the threshold for clinical significance. Higher baseline leg lymphedema scores and elevated body mass index were associated with increased 12-month lymphedema scores. A higher leg lymphedema score at 3 months correlated with an increased score at 12 months. Severe lymphedema at 12 months negatively impacted daily activities, appearance, emotional well-being, and global QoL while increasing subjective symptom burden.  

Investigators concluded that sentinel lymph node mapping in low-grade endometrial cancer posed a low lymphedema risk, with baseline leg swelling and body mass index predicting later lymphedema, early lymphedema predicting persistence, and higher 12-month scores correlating with reduced QoL. 

Source: ajog.org/article/S0002-9378(24)00904-9/fulltext