KEY TAKEAWAYS
- The study aimed to investigate the efficacy of LE in managing post-operative lymphatic leakage in patients undergoing RC with PLND.
- Researchers noticed that LE effectively addresses post-operative leaks after RC.
Although radical cystectomy (RC) along with pelvic lymph node dissection (PLND) is the standard approach for treating muscle-invasive bladder cancer (MIBC), it may lead to lymphatic leakage. Recent research has pointed to lymphatic embolization (LE) as a viable option for managing post-operative lymphatic leaks.
Consequently, Yoo Sub Shin and the team aimed to evaluate the outcomes of LE in patients who underwent RC and to analyze the factors associated with these outcomes.
They performed an inclusive analysis of patients who underwent LE after RC for BC between August 2017 and June 2023. Data were assessed for analysis in January 2024.
The patients were categorized into a clinical success group and a clinical failure group, with clinical failure defined as 1) requiring drainage catheter placement for more than 7 days after LE, 2) needing re-intervention before catheter removal, and 3) experiencing adverse events (AE) associated with LE. To identify factors associated with the outcomes of LE, a Logistic regression analysis was conducted.
About 45 patients who underwent LE after RC were analyzed. Of these 28 (62.2%) patients were classified as clinically successful, 4 patients required re-embolization, but none needed more than 2 intervention sessions. Lymphatic complications were experienced in 3 patients following LE.
In multivariable analysis, a maximal daily drainage volume of >1,000 mL/day (odds ratio [OR] = 4.729, 95% confidence interval [CI]: 1.018-21.974, P = 0.047) and diabetes mellitus (DM) (OR = 4.571, 95% CI: 1.128-18.510, P = 0.033) were identified as factors associated with the outcomes of LE.
The study concluded that LE is a potentially effective procedure for managing post-operative lymphatic leaks after RC, with few minor side effects. Patients with a daily drainage exceeding 1,000 mL/day or a medical history of diabetes mellitus are at an increased risk for re-intervention and clinical failure following LE.
The study received no funds.
Source: https://pubmed.ncbi.nlm.nih.gov/39316604/
Shin YS, Han K, Lee J, et al. (2024). “Lymphatic embolization for early post-operative lymphatic leakage after radical cystectomy for bladder cancer.” PLoS One. 2024;19(9):e0305240. Published 2024 Sep 24. doi:10.1371/journal.pone.0305240
