Increased Skin Cancer Risk in Lower Extremity Lymphedema Patients
A recent retrospective cohort study conducted at the Mayo Clinic in Rochester, MN, sought to evaluate whether individuals with lower extremity (LE) lymphedema had a higher propensity for skin cancer compared to matched controls without lymphedema. Led by Dr. Nimay C. Anand and colleagues from Meharry Medical College in Nashville, Tennessee, the study spanned from January 2000 to December 2020 and encompassed 4,437 patients with LE lymphedema, alongside age-, race-, and sex-matched controls.
The comprehensive analysis revealed a striking association between LE lymphedema and an increased risk of skin cancer. Patients with lymphedema in their lower extremities exhibited a significantly elevated risk compared to the control group. Specifically, within the subset of patients with unilateral lymphedema, the lymphedematous extremity showed 2.65 times the likelihood of developing skin cancer, particularly basal cell carcinoma, compared to the nonlymphedematous lower extremity.
The findings underscore the importance of vigilance and specialized monitoring for individuals grappling with LE lymphedema. Clinicians caring for these patients should remain vigilant and conduct regular screenings, especially considering the increased risk of skin cancer, including basal cell carcinoma and squamous cell carcinoma, as well as angiosarcoma as anticipated.
The study prompts further investigations into the underlying mechanisms and pathogenesis of skin cancer development in individuals with LE lymphedema. Dr. Anand and the research team emphasized the necessity for future studies to delve deeper into the distinctive aspects of skin cancers arising in lymphedematous lower extremities. This includes exploring whether these cancers exhibit unique histological characteristics or differ in prognostic outcomes compared to those occurring in nonlymphedematous extremities.
The study, published online in Mayo Clinic Proceedings, disclosed associations between some authors and the pharmaceutical industry, emphasizing the need for transparency regarding potential conflicts of interest in medical research.
Participants: 4,437 patients with LE lymphedema
Risk Association: Lymphedema group showed significantly increased risk of skin cancer compared to matched controls
Risk Magnitude: Lymphedematous extremity in unilateral lymphedema showed 2.65 times increased likelihood of skin cancer, notably basal cell carcinoma
This study highlights a critical consideration for clinicians, accentuating the need for tailored monitoring and vigilant care for patients coping with LE lymphedema. Further research is anticipated to illuminate the nuanced aspects of skin cancer development in this demographic, paving the way for more personalized and effective management strategies.
Reference:
Anand, N. C., Campbell, E. H., Baum, C. L., Gibson, L. E., Todd, A., Bradt, J. L., & Alavi, A. Association of lower extremity lymphedema and nonmelanoma skin cancers. Mayo Clinic Proceedings. Mayo Clinic,2023;98(11):1653–1659. https://doi.org/10.1016/j.mayocp.2023.02.030
