Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in
Cervical Cancer Patients

J 2021

Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in Cervical Cancer Patients

CIBULA, David, Martina BORCINOVA, Simone MARNITZ, Jiří JARKOVSKÝ, Jaroslav KLAT et. al.

Basic information

Original name

Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in Cervical Cancer Patients

Authors

CIBULA, David (203 Czech Republic, guarantor), Martina BORCINOVA (203 Czech Republic), Simone MARNITZ, Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), Jaroslav KLAT (203 Czech Republic), Radovan PILKA (203 Czech Republic), Aureli TORNE, Ignacio ZAPARDIEL, Almerinda PETIZ, Laura LAY, Borek SEHNAL (203 Czech Republic), Jordi PONCE, Michal FELSINGER (203 Czech Republic, belonging to the institution), Octavio ARENCIBIA-SANCHEZ, Peter KASCAK, Kamil ZALEWSKI, Jiri PRESL, Alicia PALOP-MOSCARDO, Solveig TINGULSTAD, Ignace VERGOTE, Mikulas REDECHA, Filip FRUHAUF (203 Czech Republic), Christhardt KOHLER and Roman KOCIAN (203 Czech Republic)

Edition

Cancers, BASEL, MDPI, 2021, 2072-6694

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 6.575

RIV identification code

RIV/00216224:14110/21:00121726

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.3390/cancers13102360

UT WoS

000654653300001

Keywords in English

cervical cancer; sentinel lymph node biopsy; lower limb lymphedema; pelvic lymphadenectomy

Abstract

V originále

Simple Summary Lower-limb lymphedema (LLL) is a well-recognized adverse outcome of the surgical management of cervical cancer. Recently, sentinel lymph node (SLN) biopsy has emerged as an alternative procedure to systematic pelvic lymphadenectomy (PLND) aiming to decrease the risk of complications, especially LLL development. Our study represents the first prospective analysis of LLL incidence in cervical cancer patients after a uterine procedure with SLN biopsy, without systematic PLND. In an international multicenter trial SENTIX, the group of 150 patients was prospectively evaluated using both objective and subjective LLL assessments in 6 months intervals for 2 years. Contrary to the expectations, our results showed that SLN biopsy does not eliminate the risk of LLL development which occurred in a mild or moderate stage in about 26% of patients with a median interval to the onset of 9 months. Background: To prospectively assess LLL incidence among cervical cancer patients treated by uterine surgery complemented by SLN biopsy, without PLND. Methods: A prospective study in 150 patients with stage IA1-IB2 cervical cancer treated by uterine surgery with bilateral SLN biopsy. Objective LLL assessments, based on limb volume increase (LVI) between pre- and postoperative measurements, and subjective patient-perceived swelling were conducted in six-month periods over 24-months post-surgery. Results: The cumulative incidence of LLL at 24 months was 17.3% for mild LLL (LVI 10-19%), 9.2% for moderate LLL (LVI 20-39%), while only one patient (0.7%) developed severe LLL (LVI > 40%). The median interval to LLL onset was nine months. Transient edema resolving without intervention within six months was reported in an additional 22% of patients. Subjective LLL was reported by 10.7% of patients, though only a weak and partial correlation between subjective-report and objective-LVI was found. No risk factor directly related to LLL development was identified. Conclusions: The replacement of standard PLND by bilateral SLN biopsy in the surgical treatment of cervical cancer does not eliminate the risk of mild to moderate LLL, which develops irrespective of the number of SLN removed.

Citovat

CIBULA, David, Martina BORCINOVA, Simone MARNITZ, Jiří JARKOVSKÝ, Jaroslav KLAT, Radovan PILKA, Aureli TORNE, Ignacio ZAPARDIEL, Almerinda PETIZ, Laura LAY, Borek SEHNAL, Jordi PONCE, Michal FELSINGER, Octavio ARENCIBIA-SANCHEZ, Peter KASCAK, Kamil ZALEWSKI, Jiri PRESL, Alicia PALOP-MOSCARDO, Solveig TINGULSTAD, Ignace VERGOTE, Mikulas REDECHA, Filip FRUHAUF, Christhardt KOHLER and Roman KOCIAN. Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in Cervical Cancer Patients. Cancers. BASEL: MDPI, 2021, vol. 13, No 10, p. 1-16. ISSN 2072-6694. Available from: https://dx.doi.org/10.3390/cancers13102360.

@article{1774644,
   author = {Cibula, David and Borcinova, Martina and Marnitz, Simone and Jarkovský, Jiří and Klat, Jaroslav and Pilka, Radovan and Torne, Aureli and Zapardiel, Ignacio and Petiz, Almerinda and Lay, Laura and Sehnal, Borek and Ponce, Jordi and Felsinger, Michal and ArencibiaandSanchez, Octavio and Kascak, Peter and Zalewski, Kamil and Presl, Jiri and PalopandMoscardo, Alicia and Tingulstad, Solveig and Vergote, Ignace and Redecha, Mikulas and Fruhauf, Filip and Kohler, Christhardt and Kocian, Roman},
   article_location = {BASEL},
   article_number = {10},
   doi = {http://dx.doi.org/10.3390/cancers13102360},
   keywords = {cervical cancer; sentinel lymph node biopsy; lower limb lymphedema; pelvic lymphadenectomy},
   language = {eng},
   issn = {2072-6694},
   journal = {Cancers},
   title = {Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in Cervical Cancer Patients},
   url = {https://www.mdpi.com/2072-6694/13/10/2360},
   volume = {13},
   year = {2021}
}

TY  - JOUR
ID  - 1774644
AU  - Cibula, David - Borcinova, Martina - Marnitz, Simone - Jarkovský, Jiří - Klat, Jaroslav - Pilka, Radovan - Torne, Aureli - Zapardiel, Ignacio - Petiz, Almerinda - Lay, Laura - Sehnal, Borek - Ponce, Jordi - Felsinger, Michal - Arencibia-Sanchez, Octavio - Kascak, Peter - Zalewski, Kamil - Presl, Jiri - Palop-Moscardo, Alicia - Tingulstad, Solveig - Vergote, Ignace - Redecha, Mikulas - Fruhauf, Filip - Kohler, Christhardt - Kocian, Roman
PY  - 2021
TI  - Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in Cervical Cancer Patients
JF  - Cancers
VL  - 13
IS  - 10
SP  - 1-16
EP  - 1-16
PB  - MDPI
SN  - 20726694
KW  - cervical cancer
KW  - sentinel lymph node biopsy
KW  - lower limb lymphedema
KW  - pelvic lymphadenectomy
UR  - https://www.mdpi.com/2072-6694/13/10/2360
N2  - Simple Summary Lower-limb lymphedema (LLL) is a well-recognized adverse outcome of the surgical management of cervical cancer. Recently, sentinel lymph node (SLN) biopsy has emerged as an alternative procedure to systematic pelvic lymphadenectomy (PLND) aiming to decrease the risk of complications, especially LLL development. Our study represents the first prospective analysis of LLL incidence in cervical cancer patients after a uterine procedure with SLN biopsy, without systematic PLND. In an international multicenter trial SENTIX, the group of 150 patients was prospectively evaluated using both objective and subjective LLL assessments in 6 months intervals for 2 years. Contrary to the expectations, our results showed that SLN biopsy does not eliminate the risk of LLL development which occurred in a mild or moderate stage in about 26% of patients with a median interval to the onset of 9 months. Background: To prospectively assess LLL incidence among cervical cancer patients treated by uterine surgery complemented by SLN biopsy, without PLND. Methods: A prospective study in 150 patients with stage IA1-IB2 cervical cancer treated by uterine surgery with bilateral SLN biopsy. Objective LLL assessments, based on limb volume increase (LVI) between pre- and postoperative measurements, and subjective patient-perceived swelling were conducted in six-month periods over 24-months post-surgery. Results: The cumulative incidence of LLL at 24 months was 17.3% for mild LLL (LVI 10-19%), 9.2% for moderate LLL (LVI 20-39%), while only one patient (0.7%) developed severe LLL (LVI > 40%). The median interval to LLL onset was nine months. Transient edema resolving without intervention within six months was reported in an additional 22% of patients. Subjective LLL was reported by 10.7% of patients, though only a weak and partial correlation between subjective-report and objective-LVI was found. No risk factor directly related to LLL development was identified. Conclusions: The replacement of standard PLND by bilateral SLN biopsy in the surgical treatment of cervical cancer does not eliminate the risk of mild to moderate LLL, which develops irrespective of the number of SLN removed.
ER  -

CIBULA, David, Martina BORCINOVA, Simone MARNITZ, Jiří JARKOVSKÝ, Jaroslav KLAT, Radovan PILKA, Aureli TORNE, Ignacio ZAPARDIEL, Almerinda PETIZ, Laura LAY, Borek SEHNAL, Jordi PONCE, Michal FELSINGER, Octavio ARENCIBIA-SANCHEZ, Peter KASCAK, Kamil ZALEWSKI, Jiri PRESL, Alicia PALOP-MOSCARDO, Solveig TINGULSTAD, Ignace VERGOTE, Mikulas REDECHA, Filip FRUHAUF, Christhardt KOHLER and Roman KOCIAN. Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in Cervical Cancer Patients. \textit{Cancers}. BASEL: MDPI, 2021, vol.~13, No~10, p.~1-16. ISSN~2072-6694. Available from: https://dx.doi.org/10.3390/cancers13102360.

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