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Development of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer

Moloney, Kristen ; Janda, Monika ; Frumovitz, Michael ; Leitao, Mario ; Abu-Rustum, Nadeem R. ; Rossi, Emma ; Nicklin, James L. ; Plante, Marie ; Lecuru, Fabrice R. and Buda, Alessandro , et al. (2021) In International Journal of Gynecological Cancer 31(5). p.647-655
Abstract

Sentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance. A Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews... (More)

Sentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance. A Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews identified key steps and tasks which were rated mandatory, optional, or prohibited using questionnaires. Using the surgical steps for which consensus was achieved, a competency assessment tool was developed and subjected to assessments of validity and reliability. Seventy percent consensus agreement standardized the specific mandatory, optional, and prohibited steps of SLN dissection for endometrial cancer and informed the development of a competency assessment tool. Consensus agreement identified 21 mandatory and three prohibited steps to complete a SLN dissection. The competency assessment tool was used to rate surgical quality in three preselected videos, demonstrating clear separation in the rating of the skill level displayed with mean skills summary scores differing significantly between the three videos (F score=89.4; P<0.001). Internal consistency of the items was high (Cronbach α=0.88). Specific mandatory and prohibited steps of SLN dissection in endometrial cancer have been identified and validated based on consensus among a large number of international experts. A competency assessment tool is now available and can be used for surgeon selection in clinical trials and for ongoing, prospective quality assurance in routine clinical care.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
endometrial neoplasms, operative, sentinel lymph node, surgical oncology, surgical procedures, uterine cancer
in
International Journal of Gynecological Cancer
volume
31
issue
5
pages
647 - 655
publisher
BMJ Publishing Group
external identifiers
  • scopus:85105176811
  • pmid:33664126
ISSN
1048-891X
DOI
10.1136/ijgc-2020-002315
language
English
LU publication?
yes
id
6a463414-0060-4f9b-aa55-c60744ac6f2a
date added to LUP
2021-06-03 17:47:14
date last changed
2024-06-16 14:38:34
@article{6a463414-0060-4f9b-aa55-c60744ac6f2a,
  abstract     = {{<p>Sentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance. A Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews identified key steps and tasks which were rated mandatory, optional, or prohibited using questionnaires. Using the surgical steps for which consensus was achieved, a competency assessment tool was developed and subjected to assessments of validity and reliability. Seventy percent consensus agreement standardized the specific mandatory, optional, and prohibited steps of SLN dissection for endometrial cancer and informed the development of a competency assessment tool. Consensus agreement identified 21 mandatory and three prohibited steps to complete a SLN dissection. The competency assessment tool was used to rate surgical quality in three preselected videos, demonstrating clear separation in the rating of the skill level displayed with mean skills summary scores differing significantly between the three videos (F score=89.4; P&lt;0.001). Internal consistency of the items was high (Cronbach α=0.88). Specific mandatory and prohibited steps of SLN dissection in endometrial cancer have been identified and validated based on consensus among a large number of international experts. A competency assessment tool is now available and can be used for surgeon selection in clinical trials and for ongoing, prospective quality assurance in routine clinical care.</p>}},
  author       = {{Moloney, Kristen and Janda, Monika and Frumovitz, Michael and Leitao, Mario and Abu-Rustum, Nadeem R. and Rossi, Emma and Nicklin, James L. and Plante, Marie and Lecuru, Fabrice R. and Buda, Alessandro and Mariani, Andrea and Leung, Yee and Ferguson, Sarah Elizabeth and Pareja, Rene and Kimmig, Rainer and Tong, Pearl Shuang Ye and McNally, Orla and Chetty, Naven and Liu, Kaijiang and Jaaback, Ken and Lau, Julio and Ng, Soon Yau Joseph and Falconer, Henrik and Persson, Jan and Land, Russell and Martinelli, Fabio and Garrett, Andrea and Altman, Alon and Pendlebury, Adam and Cibula, David and Altamirano, Roberto and Brennan, Donal and Ind, Thomas Edward and De Kroon, Cornelis and Tse, Ka Yu and Hanna, George and Obermair, Andreas}},
  issn         = {{1048-891X}},
  keywords     = {{endometrial neoplasms; operative; sentinel lymph node; surgical oncology; surgical procedures; uterine cancer}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{5}},
  pages        = {{647--655}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{International Journal of Gynecological Cancer}},
  title        = {{Development of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer}},
  url          = {{http://dx.doi.org/10.1136/ijgc-2020-002315}},
  doi          = {{10.1136/ijgc-2020-002315}},
  volume       = {{31}},
  year         = {{2021}},
}