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.


Journal

World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052

Informations de publication

Date de publication:
04 2023
Historique:
accepted: 14 12 2022
pubmed: 29 1 2023
medline: 3 3 2023
entrez: 28 1 2023
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

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.

Identifiants

pubmed: 36709215
doi: 10.1007/s00268-022-06882-6
pii: 10.1007/s00268-022-06882-6
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

962-974

Informations de copyright

© 2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.

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Auteurs

Giovanni E Cacciamani (GE)

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.

Luis G Medina (LG)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine,, University of Southern California, Los Angeles, CA, USA.

Aref S Sayegh (AS)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine,, University of Southern California, Los Angeles, CA, USA.

Anibal La Riva (A)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine,, University of Southern California, Los Angeles, CA, USA.
Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.

Laura C Perez (LC)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine,, University of Southern California, Los Angeles, CA, USA.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Michael B Eppler (MB)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine,, University of Southern California, Los Angeles, CA, USA.

Inderbir Gill (I)

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 (R)

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.

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