Complications and adverse events in lymphadenectomy of the inguinal area: worldwide expert consensus
Year: 2024
Type: article
Abstract: BACKGROUND: Inguinal lymph node dissection plays an important role in the management of melanoma, penile and vulval cancer. Inguinal lymph node dissection is associated with various intraoperative and postoperative complications with significant heterogeneity in classification and reporting. This lack of standardization challenges efforts to study and report inguinal lymph node dissection outcomes. The aim of this study was to devise a system to standardize the classification and reporting of inguinal lymph node dissection perioperative complications by creating a worldwide collaborative, the complications and adverse events in lymphadenectomy of the inguinal area (CALI) group. METHODS: A modified 3-round Delphi consensus approach surveyed a worldwide group of experts in inguinal lymph node dissection for melanoma, penile and vulval cancer. The group of experts included general surgeons, urologists and oncologists (gynaecological and surgical). The survey assessed expert agreement on inguinal lymph node dissection perioperative complications. Panel interrater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α. RESULTS: Forty-seven experienced consultants were enrolled: 26 (55.3%) urologists, 11 (23.4%) surgical oncologists, 6 (12.8%) general surgeons and 4 (8.5%) gynaecology oncologists. Based on their expertise, 31 (66%), 10 (21.3%) and 22 (46.8%) of the participants treat penile cancer, vulval cancer and melanoma using inguinal lymph node dissection respectively; 89.4% (42 of 47) agreed with the definitions and inclusion as part of the inguinal lymph node dissection intraoperative complication group, while 93.6% (44 of 47) agreed that postoperative complications should be subclassified into five macrocategories. Unanimous agreement (100%, 37 of 37) was achieved with the final standardized classification system for reporting inguinal lymph node dissection complications in melanoma, vulval cancer and penile cancer. CONCLUSION: The complications and adverse events in lymphadenectomy of the inguinal area classification system has been developed as a tool to standardize the assessment and reporting of complications during inguinal lymph node dissection for the treatment of melanoma, vulval and penile cancer.
Source: BJS Open
Authors: René Sotelo, Aref S Sayegh, Luis G Medina, Laura C Perez, Anibal La Riva, Michael B Eppler, José Gaona, Marcos Tobias-Machado, Philippe E Spiess, Curtis A Pettaway, Antonio Carlos Lima Pompeo, Pablo Aloisio Lima Mattos, Timothy G Wilson, Gustavo M Villoldo, Eric Chung, Aldo Samaniego, Antonio Augusto Ornellas, Vladimir Pinheiro, Eder S Brazão, David Subira-Rios, Leandro Koifman, Stênio de Cassio Zequi, Humberto M Pontillo Z, José de Ribamar Rodrigues Calixto, Rafael Campos Silva, B Mark Smithers, Simone Garzon, Oliver Haase, Antonio Sommariva, Robert Fruscio, Francisco Martins, Pedro S de Oliveira, Giovanni Battista Levi Sandri, Marco Clementi, Juan Astigueta, Islam H Metwally, Rasiah Bharathan, Tarun Jindal, Yasuhiro Nakamura, Hisham Abdel Mageed, Sakthiushadevi Jeevarajan, Ramón Rodriguez Lay, Herney Andrés García-Perdomo, Omaira Rodríguez González, Saum Ghodoussipour, Inderbir Gill, Giovanni E Cacciamani
Institutions: University of Southern California, MedStar Franklin Square Medical Center, Johns Hopkins University, Cleveland Clinic, Universidad De Santander, Moffitt Cancer Center, The University of Texas MD Anderson Cancer Center, Faculdade de Medicina do ABC, Instituto Alexander Fleming, The University of Queensland, Princess Alexandra Hospital, IPS Central, Instituto Nacional de Câncer - INCA, AC Camargo Hospital, Hospital General Universitario Gregorio Marañón, Hospital Municipal Souza Aguiar, Universidade Federal de São Paulo, Hospital Sant Jaume de Calella, Universidade Federal do Maranhão, Hospital Universitário da Universidade Federal do Maranhão, University of Verona, Charité – Universitätsmedizin Berlin, Istituto Oncologico Veneto, University of Milano-Bicocca, Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, University of L'Aquila, Antenor Orrego Private University, Mansoura University, Medical University of Vienna, Saitama International Medical Center, Saitama Medical University, Cairo University, Universidad del Valle, Universidad Central de Venezuela, Rutgers Cancer Institute
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,933
OpenAlex ID: W4400573003