前哨淋巴结定位是一种微创手术分期程序，可以识别宏观和微观转移。对患有低度子宫内膜癌的女性实施前哨淋巴结定位可以检测淋巴结转移，并避免根治性盆腔淋巴结切除术的发病率。子宫肌层浸润的程度可以高度预测淋巴结转移，但术前很难准确确定。在子宫肌层浸润<50%的大量女性中，淋巴结转移的确切发生率较低，但尚不清楚。在该组中检测转移的好处应该平衡淋巴水肿的风险。对于前哨淋巴结定位后早期和晚期淋巴水肿及其对低级别子宫内膜癌女性生活质量的影响的了解有限。主要目的是调查前哨淋巴结定位后患者报告的淋巴水肿的风险患有低度子宫内膜癌的女性。此外，我们的目的是评估术后 12 个月出现淋巴水肿的女性的淋巴水肿危险因素以及具体情况的生活质量 (QoL)。一项国家前瞻性队列研究纳入了疑似患有 I 期低级别子宫内膜癌的女性2017 年 3 月至 2022 年 2 月进行前哨淋巴结定位。女性在手术前、手术后 3 个月和 12 个月完成了一系列经过验证的患者报告的结果测量。主要结果是欧洲癌症研究和治疗组织-子宫内膜癌模块 (EORTC QLQ-EN24) 的腿部淋巴水肿领域评分。淋巴水肿评估还得到了来自欧洲癌症研究和治疗组织项目库的 7 个经过验证的单项的进一步补充，这些项目涉及腿部、生殖器和腹股沟的淋巴水肿。使用经过验证的淋巴水肿生活质量工具评估特定疾病的生活质量。评分线性变换为 0 到 100。腿部淋巴水肿总评分相对基线变化 8 分被认为具有临床重要性。估计了一段时间内的平均差异分数（置信区间为 95%）。多元线性回归模型评估了与术后 12 个月淋巴水肿评分相关的基线预测因素，以及早期淋巴水肿是否预测术后 12 个月的淋巴水肿。对患有淋巴水肿的女性进行了淋巴水肿病症特定的生活质量评估。79% (486/617) 在基线和 12 个月时完成了患者报告的结果测量。从基线到 12 个月，腿部淋巴水肿的平均差异评分为 5.0，置信区间 [3.3，6.8]，即低于临床重要性阈值。基线腿部淋巴水肿评分和体重指数与 12 个月时腿部淋巴水肿评分呈正相关。 3 个月时的腿部淋巴水肿评分与 12 个月时的评分较高相关。 12 个月时淋巴水肿的高分与女性的日常活动、外表、情绪功能和总体生活质量呈负相关，并增加了她们的主观症状负担。患有低级别子宫内膜癌的女性在前哨淋巴结切除术后发生淋巴水肿的风险较低映射。基线时腿部肿胀和体重指数预示术后 12 个月会出现更多淋巴水肿。 3 个月时的早期淋巴水肿预示着持续性淋巴水肿。 12 个月时腿部淋巴水肿评分较高与生活质量多个方面的损害相关。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

Sentinel lymph node mapping is a minimally invasive surgical staging procedure that allows identification of macro- and micrometastases. The implementation of sentinel lymph node mapping to women with low-grade endometrial cancer allows detection of lymph node metastases and avoids the morbidity of radical pelvic lymphadenectomy. The extent of myometrial invasion is highly predictive of lymph node metastases but is hard to determine precisely preoperatively. The exact rate of lymph node metastases in the large group of women with <50% myometrial invasion is low but unknown. The benefit of detecting metastases in this group should balance the risk of lymphedema. There is limited knowledge of early and late lymphedema and its impact on the quality of life in women with low-grade endometrial cancer following sentinel lymph node mapping.The primary objective was to investigate the risk of patient-reported lymphedema after sentinel lymph node mapping in women with low-grade endometrial cancer. In addition, we aimed to evaluate risk factors for lymphedema and the condition-specific quality of life (QoL) among women who reported lymphedema 12 months after surgery.Women with presumed stage I low-grade endometrial cancer were included in a national prospective cohort study on sentinel lymph node mapping from March 2017 to February 2022. Women completed a package of validated patient-reported outcome measures before surgery, 3 and 12 months after surgery. 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). The lymphedema assessment was further supplemented by 7 validated single items from the European Organisation for Research and Treatment of Cancer item library addressing lymphedema of legs, genitals, and groin. The disease-specific quality of life was assessed using the validated Lymphedema Quality of Life Tool. Scores were linearly transformed to 0 to 100. A change from baseline of 8 points in leg lymphedema sum-score was considered clinically important. Mean difference scores over time with 95% confidence interval were estimated. Multiple linear regression models evaluated baseline predictors associated with the 12 months postoperative lymphedema score, and if early lymphedema predicted lymphedema at 12 months after surgery. Lymphedema condition-specific quality of life was evaluated for women with lymphedema.Seventy-nine % (486/617) completed patient-reported outcome measures at baseline and 12 months. The mean difference score of leg lymphedema from baseline to 12 months was 5.0, confidence interval [3.3, 6.8], that is, below the threshold for clinical importance. Baseline leg lymphedema score and body mass index were positively associated with the leg lymphedema score at 12 months. The leg lymphedema score at 3 months was associated with a higher 12-month score. High scores of lymphedema at 12 months were negatively associated with the women's daily activities, appearance, emotional functioning, and global quality of life and increased their subjective symptom burden.Women with low-grade endometrial cancer have a low risk of lymphedema after sentinel lymph node mapping. Leg swelling at baseline and body mass index predicted more lymphedema at 12 months after surgery. Early lymphedema at 3 months predicted persistent lymphedema. A high leg lymphedema score at 12 months is associated with impairment in several aspects of quality of life.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.