Clinical trial NCT05388786: Complications and Adverse Events in Lymphadenectomy in the Inguinal Area
Official title: Complications and Adverse Events in Lymphadenectomy in the Inguinal Area: Delphi Consensus on Adverse Events Definition and Management
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Consensus Development
Lead sponsor: University of Southern California
Sponsor class: OTHER
First posted: 2022-05-24
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: A team of experts in open inguinal lymphadenectomy, video endoscopic inguinal lymphadenectomy (VEIL), and robotic-assisted video endoscopic inguinal lymphadenectomy (R-VEIL) in the fields of General Surgery, Gynecology Oncology, Surgical Oncology, and Urology will be invited to participate. These experts are identified according to surgical experience, research, and academic interest.

Brief summary: The investigators aim to create an effective and accurate method to report, define, and classify complications and adverse events during and after Inguinal lymph node dissection (ILND) as part of the staging and treatment for penile cancer, vulvar cancer, and melanoma. In turn, this will become an objective, efficient, and reproducible tool to facilitate comparisons across surgical approaches, techniques, and surgeons.

Detailed description: Inguinal lymph node dissection (ILND) has shown to be a necessary surgery from the oncology standpoint being extensively used as part of the staging process in malignancies of the penis, vulva, or melanoma. Moreover, the ILND has been shown to improve survival if performed in a timely manner. Yet, ILND is linked to a high rate of complications and adverse events.

Complications and adverse events' incidence are frequently used as surrogate markers of quality in surgery. However, there is tremendous heterogeneity in the report in such specifically for this procedure. Even though different classification and grading systems on surgical complications are available. There is a lack of standardization regarding the definition and classification to report ILND complications and adverse events leading to discrepancies across the literature, often interfering with the interpretation of surgical performance and quality.

This study will provide a systematic definition and classification of ILND complications and adverse events, ultimately improving the reporting of such conditions for future studies.

To create an effective and accurate method to report, define, and classify complications and adverse events during and after ILND as part of the staging and treatment for penile cancer, vulvar cancer, and melanoma. In turn, this will become an objective, efficient, and reproducible tool to facilitate comparisons across surgical approaches, techniques, and surgeons.

Eligibility criteria: Inclusion Criteria:

* Experts in open inguinal lymphadenectomy
* Experts in video endoscopic inguinal lymphadenectomy (VEIL)
* Experts in robotic video endoscopic inguinal lymphadenectomy (R-VEIL)
* Authors with at least one publication in ILND for penile cancer, vulvar cancer, or melanoma

Exclusion Criteria:

* Panelists who were not able to commit to all rounds of the modified Delphi process will be excluded

Primary outcomes:
measure: Degree of consensus
timeFrame: 1 month
Secondary outcomes:
Other outcomes:
Locations:
city: Los Angeles
country: United States
facility: University of Southern California
state: California
Study officials:
affiliation: University of Southern California
name: Rene Sotelo, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Southern California
name: Giovanni Cacciamani, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Chipollini J, Tang DH, Gilbert SM, Poch MA, Pow-Sang JM, Sexton WJ, Spiess PE. Delay to Inguinal Lymph Node Dissection Greater than 3 Months Predicts Poorer Recurrence-Free Survival for Patients with Penile Cancer. J Urol. 2017 Dec;198(6):1346-1352. doi: 10.1016/j.juro.2017.06.076. Epub 2017 Jun 23.
citation: Gkegkes ID, Minis EE, Iavazzo C. Robotic-assisted inguinal lymphadenectomy: a systematic review. J Robot Surg. 2019 Feb;13(1):1-8. doi: 10.1007/s11701-018-0823-4. Epub 2018 May 5.
citation: Munoz Guillermo V, Rosino Sanchez A, Rivero Guerra A, Barcelo Bayonas I, Pardo Martinez A, Jimenez Peralta D, Carrillo George C, Pietricica BN, Izquierdo Morejon E, Cruces de Abia FI, Romero Hoyuela A, Hita Villaplana G, Fernandez Aparicio T. [Video endoscopic inguinal lymphadenectomy in penile cancer: Systematic review.]. Arch Esp Urol. 2019 Dec;72(10):992-999. Spanish.
citation: Mitropoulos D, Artibani W, Graefen M, Remzi M, Roupret M, Truss M; European Association of Urology Guidelines Panel. Reporting and grading of complications after urologic surgical procedures: an ad hoc EAU guidelines panel assessment and recommendations. Eur Urol. 2012 Feb;61(2):341-9. doi: 10.1016/j.eururo.2011.10.033. Epub 2011 Oct 29.
citation: Dindo D, Clavien PA. What is a surgical complication? World J Surg. 2008 Jun;32(6):939-41. doi: 10.1007/s00268-008-9584-y. No abstract available.
citation: Nabavizadeh R, Petrinec B, Necchi A, Tsaur I, Albersen M, Master V. Utility of Minimally Invasive Technology for Inguinal Lymph Node Dissection in Penile Cancer. J Clin Med. 2020 Aug 3;9(8):2501. doi: 10.3390/jcm9082501.