Torrent Anna, Amengual Joana, Ruiz Angela, Serra Aina, Fuertes Laura, Sampol Catalina Maria, Ruiz Mario, Rioja Jorge, Roca Pilar, Cordoba Octavi
Gynecologic Oncology Unit, Obstetrics and Gynecology Department, Hospital Universitari Son Espases, 707120 Palma, Spain.
School of Medicine, Universitat de les Illes Balears (UIB), 07120 Palma, Spain.
Gynecol Oncol Rep. 2025 Aug 4;60:101919. doi: 10.1016/j.gore.2025.101919. eCollection 2025 Aug.
Sentinel lymph node (SLN) biopsy is increasingly replacing complete pelvic lymphadenectomy (CL) for staging early-stage endometrial cancer (EC), but its long-term impact on patients' quality of life (QoL) and lymphedema remains underexplored.
To compare overall health perception (oHP), health-related QoL (HRQoL), and symptomatic lymphedema in patients staged with SLN versus CL. Secondary objectives included the assessment of symptomatic lymphedema and surgical complications.
We conducted a prospective single-center observational study including 97 patients treated early-stage EC, with 50 undergoing SLN plus CL and 47 undergoing SLN only. Patients completed EQ-5D-3L, oHP scale (0-100), and the self-reported lower-extremity lymphedema questionnaire (LELQ) at baseline and 6-month follow-up. Multivariate analysis adjusted for confounders including surgical approach and adjuvant therapy.
At 6 months, the SLN group reported significantly better oHP (median 85 vs. 70; p = 0.001) and HRQoL impairment (median score 5 vs. 7; p = 0.001) than the CL group. Symptomatic lymphedema (LELQ > 5) was significantly lower in the SLN group (7.0 %) than in the CL group (34.4 %, p = 0.002). No significant differences in intra- or postoperative complications were observed.
SLN biopsy was associated with improved QoL and lower incidence of lymphedema compared to complete lymphadenectomy. These findings support the use of SLN mapping as the preferred nodal staging technique to minimize morbidity and enhance survivorship outcomes in early-stage EC patients.
前哨淋巴结（SLN）活检正越来越多地取代盆腔淋巴结清扫术（CL）用于早期子宫内膜癌（EC）的分期，但它对患者生活质量（QoL）和淋巴水肿的长期影响仍未得到充分研究。
比较接受SLN分期与CL分期患者的总体健康感知（oHP）、健康相关生活质量（HRQoL）和症状性淋巴水肿。次要目标包括评估症状性淋巴水肿和手术并发症。
我们进行了一项前瞻性单中心观察性研究，纳入97例早期EC患者，其中50例接受SLN活检加CL，47例仅接受SLN活检。患者在基线和6个月随访时完成EQ-5D-3L、oHP量表（0-100）和自我报告的下肢淋巴水肿问卷（LELQ）。多变量分析对包括手术方式和辅助治疗在内的混杂因素进行了校正。
在6个月时，SLN组报告的oHP明显优于CL组（中位数85对70；p = 0.001），HRQoL损害也明显较轻（中位数评分5对7；p = 0.001）。SLN组的症状性淋巴水肿（LELQ>5）明显低于CL组（7.0%对34.4%，p = 0.002）。未观察到术中或术后并发症的显著差异。
与根治性淋巴结清扫术相比，SLN活检与QoL改善和较低的淋巴水肿发生率相关。这些发现支持将SLN定位作为首选的淋巴结分期技术，以尽量减少发病率并提高早期EC患者的生存结局。
