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. 2024 Jul 2;8(4):zrae056.
doi: 10.1093/bjsopen/zrae056.

Complications and adverse events in lymphadenectomy of the inguinal area: worldwide expert consensus

René Sotelo  1 , Aref S Sayegh  1   2 , Luis G Medina  1 , Laura C Perez  1   3 , Anibal La Riva  1   4 , Michael B Eppler  1 , José Gaona  5 , Marcos Tobias-Machado  6 , Philippe E Spiess  7 , Curtis A Pettaway  8 , Antonio Carlos Lima Pompeo  9 , Pablo Aloisio Lima Mattos  10 , Timothy G Wilson  11 , Gustavo M Villoldo  12 , Eric Chung  13 , Aldo Samaniego  14 , Antonio Augusto Ornellas  15 , Vladimir Pinheiro  16 , Eder S Brazão Jr  16 , David Subira-Rios  17 , Leandro Koifman  18 , Stênio de Cassio Zequi  19   20   21 , Humberto M Pontillo Z  22 , José de Ribamar Rodrigues Calixto  23 , Rafael Campos Silva  24 , B Mark Smithers  25 , Simone Garzon  26 , Oliver Haase  27 , Antonio Sommariva  28 , Robert Fruscio  29 , Francisco Martins  30 , Pedro S de Oliveira  30 , Giovanni Battista Levi Sandri  31 , Marco Clementi  32 , Juan Astigueta  33 , Islam H Metwally  34 , Rasiah Bharathan  35 , Tarun Jindal  36 , Yasuhiro Nakamura  37 , Hisham Abdel Mageed  38 , Sakthiushadevi Jeevarajan  39 , Ramón Rodriguez Lay  40 , Herney Andrés García-Perdomo  41 , Omaira Rodríguez González  42 , Saum Ghodoussipour  43 , Inderbir Gill  1 , Giovanni E Cacciamani  1
Affiliations

Complications and adverse events in lymphadenectomy of the inguinal area: worldwide expert consensus

René Sotelo et al. BJS Open. .

Erratum in

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.

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Figures

Fig. 1
Fig. 1
Demographic distribution of panellists
Fig. 2
Fig. 2
Sample round 2 results following the first round and feedback CALI, complications and adverse events in lymphadenectomy of the inguinal area.
Fig. 3
Fig. 3
Sample round 3 results following the second round and feedback CALI, complications and adverse events in lymphadenectomy of the inguinal area.
Fig. 4
Fig. 4
Standardized classification system for reporting ILND complications in melanoma, vulval cancer and penile cancer ILND, inguinal lymph node dissection; SSI, surgical site infection.
See this image and copyright information in PMC

References

    1. Cacciamani GE, Medina LG, Sayegh AS, La Riva A, Perez LC, Eppler MB et al. Assessment and reporting of perioperative adverse events and complications in patients undergoing inguinal lymphadenectomy for melanoma, vulval cancer, and penile cancer: a systematic review and meta-analysis. World J Surg 2023;47:962–974 - PubMed
    1. Greer BE, Koh W-J. New NCCN guidelines for vulval cancer. J Natl Compr Canc Netw 2016;14:656–658 - PubMed
    1. Swetter SM, Thompson JA, Albertini MR, Barker CA, Baumgartner J, Boland G et al. NCCN guidelines® insights: melanoma: cutaneous, version 2.2021: featured updates to the NCCN guidelines. J Natl Compr Canc Network 2021;19:364–376 - PubMed
    1. Clark PE, Spiess PE, Agarwal N, Biagioli MC, Eisenberger MA, Greenberg RE et al. Penile cancer. J Natl Compr Canc Network 2013;11:594–615 - PMC - PubMed
    1. Hakenberg OW, Compérat EM, Minhas S, Necchi A, Protzel C, Watkin N. EAU guidelines on penile cancer: 2014 update. Eur Urol 2015;67:142–150 - PubMed