Association of Lower Extremity Lymphedema and Nonmelanoma Skin Cancers

To determine whether patients with lymphedema of a lower extremity (LE) had a greater risk of skin cancer than those without lymphedema. This retrospective cohort study included patients with LE lymphedema examined at Mayo Clinic in Rochester, MN, USA, from January 1, 2000, through December 31, 2020...

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Bibliographic Details
Published in:Mayo Clinic proceedings 2023-11, Vol.98 (11), p.1653-1659
Main Authors: Anand, Nimay C., Campbell, Elliott H., Baum, Christian L., Gibson, Lawrence E., Todd, Austin, Bradt, Jennifer L., Alavi, Afsaneh
Format: Article
Language:English
Subjects:
Complications and side effects
Extremities, Lower
Health aspects
Leg
Lymphedema
Risk factors
Skin cancer
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Summary:To determine whether patients with lymphedema of a lower extremity (LE) had a greater risk of skin cancer than those without lymphedema. This retrospective cohort study included patients with LE lymphedema examined at Mayo Clinic in Rochester, MN, USA, from January 1, 2000, through December 31, 2020. All patients with the phrase “lower extremity lymphedema” and a diagnostic code for lymphedema present in their electronic health record, as well as their age-, race-, and sex-matched controls without lymphedema, were included in the study. A Kaplan-Meier curve was constructed to examine the time to development of the first skin cancer for the lymphedema cohort and the controls. A Cox proportional hazards regression model was used to calculate hazard ratios. In total, 4437 patients had lymphedema within the study period. Compared with the matched control group, the lymphedema group had a significantly increased risk of skin cancer. For the subset of patients with unilateral lymphedema, the lymphedematous extremity was 2.65 times as likely as the nonlymphedematous LE to have skin cancer, particularly basal cell carcinoma. Lower extremity lymphedema appears to be a risk factor for all types of LE skin cancer. Clinicians caring for patients with LE lymphedema should be aware of this increased risk and monitor at-risk patients accordingly.
ISSN:0025-6196
1942-5546
DOI:10.1016/j.mayocp.2023.02.030