Assessment and Reporting of Perioperative Adverse Events and Complications in Patients Undergoing Inguinal Lymphadenectomy for Melanoma, Vulvar Cancer, and Penile Cancer: A Systematic Review and Meta-analysis

Giovanni E Cacciamani; Luis G Medina; Aref S Sayegh; Anibal La Riva; Laura C Perez; Michael B Eppler; Inderbir Gill; Rene Sotelo; Complications and Adverse Events in Lymphadenectomy of the Inguinal Area (CALI) project, the International Consensus Panel on Complications in Urology (ICPCU), and the Intraoperative Complications assessment and reporting with Universal Standards (ICARUS) Global Surgical Collaboration

doi:10.1007/s00268-022-06882-6

Assessment and Reporting of Perioperative Adverse Events and Complications in Patients Undergoing Inguinal Lymphadenectomy for Melanoma, Vulvar Cancer, and Penile Cancer: A Systematic Review and Meta-analysis

World J Surg. 2023 Apr;47(4):962-974. doi: 10.1007/s00268-022-06882-6. Epub 2023 Jan 28.

Authors

Affiliations

¹ Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine,, University of Southern California, Los Angeles, CA, USA. Giovanni.cacciamani@med.usc.edu.
² Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine,, University of Southern California, Los Angeles, CA, USA.
³ Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
⁴ Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁵ Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine,, University of Southern California, Los Angeles, CA, USA. rene.sotelo@med.usc.edu.

^# Contributed equally.

PMID: 36709215
DOI: 10.1007/s00268-022-06882-6

Abstract

Background: Inguinal lymph node dissection (ILND) plays a crucial role in the oncological management of patients with melanoma, penile, and vulvar cancer. This study aims to systematically evaluate perioperative adverse events (AEs) in patients undergoing ILND and its reporting.

Methods: A systematic review was conducted according to PRISMA. PubMed, MEDLINE, Scopus, and Embase were queried to identify studies discussing perioperative AEs in patients with melanoma, penile, and vulvar cancer following ILND.

Results: Our search generated 3.469 publications, with 296 studies meeting the inclusion criteria. Details of 14.421 patients were analyzed. Of these studies, 58 (19.5%) described intraoperative AEs (iAEs) as an outcome of interest. Overall, 68 (2.9%) patients reported at least one iAE. Postoperative AEs were reported in 278 studies, combining data on 10.898 patients. Overall, 5.748 (52.7%) patients documented ≥1 postoperative AEs. The most reported ILND-related AEs were lymphatic AEs, with a total of 4.055 (38.8%) events. The pooled meta-analysis confirmed that high BMI (RR 1.09; p = 0.006), ≥1 comorbidities (RR 1.79; p = 0.01), and diabetes (RR 1.81; p = < 0.00001) are independent predictors for any AEs after ILND. When assessing the quality of the AEs reporting, we found 25% of studies reported at least 50% of the required criteria.

Conclusion: ILND performed in melanoma, penile, and vulvar cancer patients is a morbid procedure. The quality of the AEs reporting is suboptimal. A more standardized AEs reporting system is needed to produce comparable data across studies for furthering the development of strategies to decrease AEs.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Female
Humans
Lymph Node Excision / adverse effects
Lymph Node Excision / methods
Lymphatic Vessels* / pathology
Male
Melanoma* / surgery
Penile Neoplasms* / pathology
Penile Neoplasms* / surgery
Vulvar Neoplasms* / etiology
Vulvar Neoplasms* / surgery