Port Site Metastases: A Survey of the Society of Gynecologic Oncology and Commentary on the Clinical Workup and Management of Port Site Metastases

Baptiste, Caitlin; Meritens, Alexandre Buckley de; Jones, Nathaniel; Paer, Sudeshna Chatterjee; Tergas, Ana I.; Hou, June Y.; Wright, Jason D.; Burke, William M.

doi:10.1016/j.jmig.2017.01.011

Cited by 6 publications

(8 citation statements)

References 22 publications

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“…However, some studies have reported postoperative port site metastasis in gynecologic oncology [1], hepatocellular carcinoma [2–4], renal pelvis carcinoma [5], prostate cancer [6], and gallbladder carcinoma [7]. Here we report a rare case of port site metastasis that was successfully treated 7 years after laparoscopic nephrectomy.…”

Section: Introductionmentioning

confidence: 92%

Port site recurrence after laparoscopic radical nephrectomy: a case report

et al. 2017

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BackgroundDue to the recent development of laparoscopic devices, laparoscopic radical nephrectomy is the standard procedure for localized renal cell carcinoma. However, some studies have reported postoperative port site metastasis in several cancers.Case presentationA 68-year-old Asian-Japanese man was referred to our hospital for a further examination of his right renal tumor in 2009. Due to a clinical suspicion of renal cell carcinoma, laparoscopic nephrectomy was performed. The histopathological diagnosis was clear cell renal cell carcinoma. Follow-up computed tomography revealed a mass between the internal oblique muscle of his abdomen and the transverse muscle of his abdomen in 2014. The tumor size gradually increased, and positron emission tomography-computed tomography revealed the accumulation of fludeoxyglucose in that tumor with maximum standardized uptake value of 2.7. Based on these findings, port site recurrence was suspected, and tumor resection was performed in 2017. The pathological diagnosis was metastatic clear cell renal cell carcinoma.ConclusionsHere we report a rare case of port site metastasis that was successfully treated 7 years after laparoscopic nephrectomy.

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Section: Introductionmentioning

confidence: 92%

Port site recurrence after laparoscopic radical nephrectomy: a case report

et al. 2017

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“…to several case reports of patients, who developed PSM after uncontained extraction of malignant tissue. 26,27 Current practices by oncologic surgeons was recently reviewed by Baptiste et al 28 In a survey of 132 members of the Society of Gynecologic Oncology, the authors studied the association between preventative measures and PSM. 28 Moreover, the study compared surgeons with PSM cases versus no prior cases in regards to pneumoinsufflation pressure, mode of delivery of the specimen, use of local anesthesia at port site incisions, and method of desufflation.…”

Section: Risk Factors and Preventive Measuresmentioning

confidence: 99%

Port-Site Metastasis in Gynecological Malignancies

Benabou

Khadraoui

Khader

et al. 2021

JSLS

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Background: Minimally invasive oncologic surgery has become the standard of care in many gynecologic cancers. While laparoscopic surgery provides many benefits to patients, such as faster recovery, there are unique challenges associated with minimally invasive techniques. Port-site metastasis is a rare complication after laparoscopic oncologic surgery in management of gynecologic malignancies.Methods: We present the case of a 44-year-old female with isolated port-site recurrence following laparoscopic radical hysterectomy with node-negative, clinical stage IB1 cervical adenocarcinoma. In addition, we provide an updated review of the literature on management and oncologic outcomes of port-site metastasis. Conclusion:Port-site metastasis prevention necessitates a better understanding of underlying risk factors and pathophysiology in order to optimize outcomes. Future studies are needed on risk-reducing strategies and standardization of management for port-site metastasis.

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“…PSM prevalence has been shown to be related to tumor aggressiveness (higher tumor stage, high-grade histology or large volume of ascites). 4,12,19,25 Hence, undertaking laparoscopy in patients with advanced disease, high-risk histology, or ascites is not recommended. 32,36 In their multivariate analysis, Ataseven and collaborators identified that advanced tumor stage, positive lymph-node status, and large-volume ascites were risk factors for PSM in patients with epithelial ovarian cancer undergoing diagnostic laparoscopy.…”

Section: Patient Selectionmentioning

confidence: 99%

“…13,14 Management of PSM with multiple metastases follows the general principles of treating a systematic recurrence, but iPSM treatment is controversial. 12 The small number of reported cases has limited the conclusions that can be drawn regarding iPSM management. Surgical excision alone, surgical excision and adjuvant chemoradiotherapy, or radiotherapy alone for iPSM management have been reported, but the outcomes have been heterogeneous.…”

Section: Introductionmentioning

confidence: 99%

“… 3 , 10 Isolated port-site metastasis (iPSM; also known as “solitary port-site metastasis”) denotes tumor recurrence at trocar sites without evidence of concomitant metastasis. 11 , 12 Conversely, PSM with simultaneous metastasis in other locations (“non-isolated PSM”) is usually regarded as a part of systemic recurrence. 5 It has not been demonstrated that all patients with PSM carry a worse prognosis, but some studies have suggested that the PSM associated with multilocal recurrence has an adverse impact upon survival.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>The Pathogenesis and Prevention of Port-Site Metastasis in Gynecologic Oncology</p>

Gao¹,

Guo²,

Wang³

2020

CMAR

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Port-site metastasis (PSM) is a specific and challenging complication of laparoscopic gynecologic oncologic procedures. Research has demonstrated that PSM is associated with significant morbidity and poor outcome. The exact pathogenesis of PSM in gynecologic patients is not clear. Several preventive measures of PSM have been addressed in the relevant literature, and novel approaches to prevent this uncommon complication keep emerging. In this review, we summarized the potential mechanisms of PSM and discuss the controversies and merits of proposed preventive measures of PSM in gynecologic oncology. We undertook a literature search using the Medline database to identify studies on the pathogenesis and prevention of laparoscopic PSM. Hypotheses of PSM pathogeneses center on the immune response, pneumoperitoneum, wound contamination, and surgical method. Cogent evidence of effective prevention of PSM after laparoscopic surgery is lacking. Traditional preventive actions such as irrigation and tumor manipulation should be taken individually. Insufflation of hyperthermic CO 2 and humidified CO 2 leads to a better outcome in patients with a malignant tumor who undergo a laparoscopic procedure compared with normal CO 2 pneumoperitoneum. Port-site resection shows no advantage in survival and results in more wound events. PSM prevention plays a crucial part in the overall care of patients with gynecologic malignancies who undergo laparoscopic procedures.

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Port Site Metastases: A Survey of the Society of Gynecologic Oncology and Commentary on the Clinical Workup and Management of Port Site Metastases

Cited by 6 publications

References 22 publications

Port site recurrence after laparoscopic radical nephrectomy: a case report

Port site recurrence after laparoscopic radical nephrectomy: a case report

Port-Site Metastasis in Gynecological Malignancies

<p>The Pathogenesis and Prevention of Port-Site Metastasis in Gynecologic Oncology</p>

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