A Service Development Evaluation of Retrospective Data Exploring Prophylactic Risk-Reducing Advice for Patients with...

Patients at risk of lymphedema following pelvic lymph-node dissection for gynecologic cancers (PLND) often receive prophylactic risk-reducing advice and compression stockings to wear for 6 months, without clear supportive evidence or evaluation of the impact. This study explored if these measures affected lymphedema development 1 year after PLND. Relevant data of patients who had undergone PLND over a 10-year period were allocated into 2 groups: Group A had data on patients who received prophylactic lymphedema risk-reduction advice and compression stockings for to wear for 6 months. Group B had data on patients who did not receive prophylactic lymphedema risk-reduction advice or prophylactic compression stockings. Exclusion criteria were preexisting swelling, medication that increased edema, symptom management during end-of-life care. Data were analyzed for statistical significance between the groups. Of 108 patients, 19/60 patients (35%) in Group A and 6/48 (12.5%) patients in Group B developed lymphedema. There was no statistical difference between the groups for the presence of lymphedema. This study did not show that prophylactic compression stockings reduced the development of lymphedema but suggested an increased awareness of the signs and symptoms of lymphedema among patients who received risk-reducing education and the compression garments. These results should be tested in a prospective, controlled trial, and suggest that a change in current clinical practice is appropriate. (J GYNECOL SURG 36:198).