Complications and Adverse Events in Lymphadenectomy in the Inguinal Area

Consensus Development Clinical Trial

Official title:

Complications and Adverse Events in Lymphadenectomy in the Inguinal Area: Delphi Consensus on Adverse Events Definition and Management

Clinical Trial Details — Status: Enrolling by invitation

Administrative data

• NCT number: NCT05388786
• Other study ID #: UP-22-00368
• Status: Enrolling by invitation
• Start date: June 1, 2023
• Est. completion date: December 15, 2024

Study information

• Verified date: April 2023
• Source: University of Southern California
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Enrolling by invitation
• Enrollment: 200
• Est. completion date: December 15, 2024
• Est. primary completion date: June 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

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

Related Conditions & MeSH terms

• Consensus Development

Intervention

Behavioral:
• Delphi Questionnaire
An invitation email, including a link to the survey, will be sent to the panel of experts in ILND for penile cancer, vulvar cancer, and melanoma. The Delphi questionnaire will be administered via Welphi.com. In the first survey, panel members will outline the ILND complications and adverse events definition and classification with a series of 5-point Likert scale assessments and options for free-text responses relating to the surgeon's perception. The experts will fill out the online questionnaire. For the questions that do not reach a consensus of more than 80% in the first round or need further explanation, additional rounds of the survey may be performed.

Locations

Country	Name	City	State
United States	University of Southern California	Los Angeles	California

Sponsors (1)

Lead Sponsor	Collaborator
University of Southern California

Country where clinical trial is conducted

United States, 

References & Publications (6)

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. — View 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. — View 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. — View 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. — View 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. — View 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. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Degree of consensus	The level of agreement for all statements achieving consensus from the expert panel; consensus is predefined as = 80% of the panel rating a given statement	1 month