MP54-17 THE PREVALENCE, RISK FACTORS AND IMPACT ON QUALITY OF LIFE OF LYMPHEDEMA AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY WITH EXTENDED PELVIC LYMPH NODE DISSECTION.

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy III (MP54)1 Apr 2019MP54-17 THE PREVALENCE, RISK FACTORS AND IMPACT ON QUALITY OF LIFE OF LYMPHEDEMA AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY WITH EXTENDED PELVIC LYMPH NODE DISSECTION. Yannic Raskin*, Cedric Jorissen, Steven Joniau, and Wouter Everaerts Yannic Raskin*Yannic Raskin* More articles by this author , Cedric JorissenCedric Jorissen More articles by this author , Steven JoniauSteven Joniau More articles by this author , and Wouter EveraertsWouter Everaerts More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556678.70718.d6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: The therapeutic benefit of an extended pelvic lymph node dissection (ePLND) in the surgical treatment of localized prostate cancer is still open for debate. On the other hand, an ePLND is associated with significant additional peri- and postoperative complications, the most frequent one being secondary lymphedema. In this single center prospective analysis, we aim to determine the prevalence, possible risk factors and the effect on quality of life. METHODS: We have prospectively registered 139 patients who received a robot-assisted radical prostatectomy with ePLND from 2015 to 2018 at our center. Exclusion criteria were conversion to open procedure, salvage cases and follow-up <5mo. The presence of lymphedema was evaluated in a standardized manner. Quality of life was assessed for by the EORTC QLQ-C30. Four possible risk factors were analyzed: BMI, age, adjuvant radiotherapy and presence of a symptomatic lymphocele. RESULTS: After applying inclusion and exclusion criteria, the study population counted 139 patients. In 29/139 (20.8%) patients, lymphedema was present during the last consultation. Significant swelling existed in 16/29 (55.1%) patients in the upper left leg, in 15/29 (51.7%) in the upper right leg, in 14/29 (48.2%) in the lower left leg and in 17/29 (58.6%) in the lower right leg. Bilateral lymphedema occurred in 15/29 (51.7%) patients. Two patients (6.9%) presented with scrotal edema. Mean age was 64,7yo (SD ± 6.22) in the lymphedema group vs. 64,5yo (SD ± 6.75, p=0.974) in the non-lymphedema group. Mean pre-operative BMI was 27.4 kg/m2 (SD ± 3.61) vs. 26.25 kg/m2 (SD ± 2.96, p=0.161). Adjuvant radiotherapy was administered in 9/29 (31%) vs. 11/110 (10%, p=0.004). A symptomatic lymphocele formation had been present in 5/29 (17.2%) vs. 9/110 (8.2%, p=0.149). EORTC QLQ-C30 subgroups rated: global health status (80.39 vs 73.69), physical functioning (93.83 vs 85.88), role functioning (95.22 vs 77.54), emotional functioning (85.6 vs 76.62) and social functioning (92.67 vs 80.08). CONCLUSIONS: The prevalence of lymphedema after ePLND during radical prostatectomy (20.8 %) is much higher than previously reported. Lymphedema is associated with important effects on the physical and emotional well-being of patients. We confirm adjuvant radiotherapy as a risk factor for the development of lymphedema, whereas age, BMI and symptomatic lymphoceles were not withheld. Source of Funding: None Leuven, Belgium© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e791-e791 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yannic Raskin* More articles by this author Cedric Jorissen More articles by this author Steven Joniau More articles by this author Wouter Everaerts More articles by this author Expand All Advertisement PDF downloadLoading ...