• Luca G Campana, Sofia Farronato, Jackie Hodgetts, Joy Odili, Antonella Vecchiato, Alison Bracken, Susanne Baier, Falk G Bechara, Lorenzo Borgognoni, Corrado Caracò, Sara Carvalhal, Piero Covarelli, James Clover, Klaus Eisendle, Fabrizio Fantini, Maria Teresa Fierro, Victor Farricha, Chiara Gregorelli, Jürg Hafner, Christian Kunte, Gianni Gerlini, Schapoor Hessam, Mario Mandalà, Dario Piazzalunga, Pietro Quaglino, Marko Snoj, Alastair Mackenzie Ross, Béatrice Trigona, David Moreno-Ramirez, Francesca Tauceri, Howard Peach, Piotr Rutkowski, Tobian Muir, Francesca de Terlizzi, Roberto Patuzzo, Michael Mühlstädt, Karin-Almut Dietrich, Thomas Mussack, Paolo Matteucci, Erika Kis, Paolo Ascierto, Gregor Sersa, Sara Valpione, and Melanoma Delphi Working Group.
• Department of Surgery, Manchester University NHS Foundation Trust, Manchester, UK.
• Br J Surg. 2023 Jun 12; 110 (7): 818830818-830.

BackgroundSkin metastases are an important co-morbidity in melanoma. Despite broad adoption, electrochemotherapy implementation is hindered by a lack of treatment indications, uncertainty regarding procedural aspects, and the absence of quality indicators. An expert consensus may harmonize the approach among centres and facilitate comparison with other therapies.MethodsAn interdisciplinary panel was recruited for a three-round e-Delphi survey. A literature-based 113-item questionnaire was proposed to 160 professionals from 53 European centres. Participants rated each item for relevance and degree of agreement on a five-point Likert scale, and received anonymous controlled feedback to allow revision. The items that reached concordant agreement in two successive iterations were included in the final consensus list. In the third round, quality indicator benchmarks were defined using a real-time Delphi method.ResultsThe initial working group included 122 respondents, of whom 100 (82 per cent) completed the first round, thus qualifying for inclusion in the expert panel (49 surgeons, 29 dermatologists, 15 medical oncologists, three radiotherapists, two nurse specialists, two clinician scientists). The completion rate was 97 per cent (97 of 100) and 93 per cent (90 of 97) in the second and third rounds respectively. The final consensus list included 54 statements with benchmarks (treatment indications, (37); procedural aspects, (1); quality indicators, (16)).ConclusionAn expert panel achieved consensus on the use of electrochemotherapy in melanoma, with a core set of statements providing general direction to electrochemotherapy users to refine indications, align clinical practices, and promote quality assurance programmes and local audits. The residual controversial topics set future research priorities to improve patient care.© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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