Association of Lower Extremity Lymphedema and Nonmelanoma Skin Cancers

Objective: To determine whether patients with lymphedema of a lower extremity (LE) had a greater risk of skin cancer than those without lymphedema. Patients and Methods: 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 pro-portional hazards regression model was used to calculate hazard ratios. Results: 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. Conclusion: Lower extremity lymphedema appears to be a risk factor for squamous cell carcinoma, basal call carcinoma, and as expected, angiosarcoma. Clinicians caring for patients with LE lymphe-dema should be aware of this increased risk and monitor at-risk patients accordingly. (c) 2023 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved. center dot Mayo Clin Proc. 2023;98(11):1653-1659

Automated summary

This study found that patients with lymphedema of a lower extremity have a greater risk of skin cancer compared to those without lymphedema. For patients with unilateral lymphedema, the lymphedematous extremity is 2.65 times more likely to develop skin cancer than the nonlymphedematous lower extremity.