Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Rethinking lymphoedema prophylaxis after groin dissection for melanoma (141305)

Teresa S Lee 1 2 , Melody Brown 3 , Isabel Li 1 , Christopher Allan 3
  1. University of Sydney, Sydney, New South Wales, Australia, New South Wales, Australia
  2. Royal North Shore Hospital, Sydney, New South Wales, Australia, NEW SOUTH WALES, Australia
  3. Mater Hospital, Brisbane, Queensland, Australia

Aims
Lower limb lymphoedema affects approximately one third of patients following groin dissection for metastatic melanoma and can significantly impair function and quality of life (QoL). Evidence supporting early surveillance and prophylactic compression strategies in melanoma populations remains limited. This study evaluated whether a 6-month program of compression garments combined with simple lymphatic drainage (CG-SLD) reduces postoperative lymphoedema compared with standard care (SC).

Methods
Participants were randomised 1:1 to SC or CG-SLD for 6 months following surgery. Lymphoedema was assessed pre-operatively and every 3 months for 24 months using inter-limb volume difference and bioimpedance spectroscopy. The primary endpoint was lymphoedema incidence at 24 months. Secondary outcomes included time to lymphoedema development, severity and QoL. The study was powered to detect a reduction in incidence from 45% to 18%, requiring 88 participants.

Results
Thirty-eight participants were randomised (SC n = 20; CG-SLD n = 18), below the planned sample size. During the intervention period, lymphoedema incidence was lower with CG-SLD (3 months: 11.1% vs. 45%; 6 months: 16.7% vs. 50%), with reduced early severity. By 24 months, overall lymphoedema incidence remained high (47.4%), with no statistically significant difference between groups: SC 55.0% (31.5–76.9) versus CG-SLD 38.9% (17.3–64.3; p = 0.4). All new lymphoedema events occurred within 12 months. There were no statistical differences in QoL outcomes between groups.

Conclusions
CG-SLD did not significantly reduce lymphoedema incidence at 24 months compared with SC. However, early reductions in lymphoedema incidence and severity suggest prophylactic compression may delay, rather than prevent, lymphoedema development following groin dissection. Although limited by under-recruitment, these findings support further investigation into longer-duration interventions and risk-stratified prophylactic strategies to determine whether sustained reductions in lymphoedema burden can be achieved in high-risk melanoma populations.