Standardizing Melanoma Inguinal Lymphadenectomy Complications

July, 07, 2024 | Genitourinary Cancer, Gynecologic Cancer, Melanoma, Skin Cancer

KEY TAKEAWAYS

  • The study aimed to standardize the classification and reporting of perioperative complications in inguinal lymph node dissection through the CALI group.
  • Researchers concluded that CALI standardizes inguinal lymph node dissection complication reporting for melanoma, vulval, and penile cancer treatments.

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.

René Sotelo and the team aimed 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 (AEs) in lymphadenectomy of the inguinal area (CALI) group.

They conducted an inclusive analysis using a modified 3-round Delphi consensus approach involving a global panel of experts in inguinal lymph node dissection for melanoma, penile, and vulval cancer. The expert group comprised general surgeons, urologists, and oncologists specializing in gynecology and surgery.

The survey evaluated expert consensus on perioperative complications associated with inguinal lymph node dissection. Panel interrater agreement and consistency were measured by overall percentage agreement and Cronbach’s α.

About 47 experienced consultants participated: 26 (55.3%) urologists, 11 (23.4%) surgical oncologists, 6 (12.8%) general surgeons, and 4 (8.5%) gynecology oncologists. Among them, 31 (66%), 10 (21.3%), and 22 (46.8%) treat penile cancer, vulval cancer, and melanoma with 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 5 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.

The study concluded that the complications and AEs in lymphadenectomy of the inguinal area classification system serve as a standardized tool for assessing and reporting complications during inguinal lymph node dissection in melanoma, vulval, and penile cancer treatment.

The study received no funds.

Source: https://pubmed.ncbi.nlm.nih.gov/38987232

Sotelo R, Sayegh AS, Medina LG, et al. (2024). “Complications and adverse events in lymphadenectomy of the inguinal area: worldwide expert consensus.” BJS Open. 2024 Jul 2;8(4):zrae056. doi: 10.1093/bjsopen/zrae056. PMID: 38987232; PMCID: PMC11236483.

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