Port Site Metastasis after Surgery for Renal Cell Carcinoma: Harbinger of Future Metastasis

Song, Joseph; Kim, Eric; Mobley, Jonathan; Vemana, Goutham; Tanagho, Youssef S.; Vetter, Joel; Bhayani, Sam B.; Russo, Paul; Fugita, Oscar Eduardo Hidetoshi; Yang, Stephen Shei‐Dei; Iwamura, Masatsugu; Figenshau, R. Sherburne

doi:10.1016/j.juro.2014.02.089

Cited by 46 publications

(20 citation statements)

References 28 publications

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“…Recently, Song et al . reported port site metastasis in a total of 16 cases [12]. Our case was initially diagnosed as pT1a, G1 > G2 clear cell renal cell carcinoma and carried quite a low risk compared to the previous report.…”

Section: Discussionmentioning

confidence: 62%

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: Discussionmentioning

confidence: 62%

Port site recurrence after laparoscopic radical nephrectomy: a case report

et al. 2017

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“…The presented study included several recently published trials and also excluded some studies with both EGC and AGC patients, which enlarged the case pool and eliminated confounding bias at the same time. Port-site metastasis is proposed to be one disadvantage of laparoscopic surgery and could occur in different kinds of malignant cancers [114]; moreover, portsite metastasis might indicate a harbinger of progressive disease [115]. Although it occurred rarely in LG for EGCs, the incidence of port-site metastasis after LG in AGCs is largely unknown [116].…”

Section: Discussionmentioning

confidence: 99%

Comparison of laparoscopic versus open gastrectomy for advanced gastric cancer: an updated meta-analysis

Quan

Huang

et al. 2015

Gastric Cancer

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Background Laparoscopic gastrectomy (LG) has been used as an alternative to open gastrectomy (OG) to treat early gastric cancer. However, the use of LG for advanced gastric cancer (AGC) has been in debate. Methods Literature retrieval was performed by searching PubMed, EMBASE, and the Cochrane library up to July 2014. Potential studies comparing the surgical effects between LG with OG were evaluated and data were extracted accordingly. Meta-analysis was carried out using RevMan. The pooled risk ratio and weighted mean difference (WMD) with 95 % confidence interval (95 % CI) were calculated. Results Overall, 26 studies were included in this metaanalysis. LG had some advantages over OG, including shorter hospitalization (WMD, -3.63, 95 % CI, -4.66 to -2.60; P \ 0.01), less blood loss (WMD, -161.37, 95 % CI, -192.55 to -130.18; P \ 0.01), faster bowel recovery (WMD, -0.78, 95 % CI, -1.05 to -0.50; P \ 0.01), and earlier ambulation (WMD, -0.95, 95 % CI, -1.47 to -0.44; P \ 0.01). In terms of surgical and oncological safety, LG could achieve similar lymph nodes (WMD, -0.49, 95 % CI, -1.78 to 0.81; P = 0.46), a lower complication rate [odds ratio (OR), 0.71, 95 % CI, 0.59 to 0.87; P \ 0.01], and overall survival (OS) and disease-free survival (DFS) comparable to OG. Conclusions For AGCs, LG appeared comparable with OG in short-and long-term results. Although more time was needed to perform LG, it had some advantages over OG in achieving faster postoperative recovery. Ongoing trials and future studies could help to clarify this controversial issue.

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“…However, previous studies showed decreased number of harvested lymph nodes for gastric patients during LG compared with OG [12,13]. Besides, like all the laparoscopic procedure, port site metastases and seeding during LG were inevitable because of intra-abdominal hyperpressure and adherence of laparoscopic instrument [14][15][16][17]. What is more, though there are some studies comparing the secondary outcomes between the LG and OG groups, lack of long-term oncological outcomes such as recurrence and mortality hinders its full support as a valid procedure [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic versus open gastrectomy for gastric cancer

et al. 2020

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Background:Compared with open gastrectomy (OG), laparoscopic gastrectomy (LG) for gastric cancer has achieved rapid development and popularities in the past decades. However, lack of comprehensive analysis in longterm oncological outcomes such as recurrence and mortality hinder its full support as a valid procedure. Therefore, there are still debates on whether one of these options is superior. Aim: To evaluate the primary and secondary outcomes of laparoscopic versus open gastrectomy for gastric cancer patients Methods: Two authors independently extracted study data. Risk ratio (RR) with 95% confidence interval (CI) was calculated for binary outcomes, mean difference (MD) or the standardized mean difference (SMD) with 95% CI for continuous outcomes, and the hazard ratio (HR) for time-to-event outcomes. Review Manager 5.3 and STATA software were used for the meta-analysis.Results: Seventeen randomized controlled trials (RCTs) involving 5204 participants were included in this metaanalysis. There were no differences in the primary outcomes including the number of lymph nodes harvested during operation, severe complications, short-term and long-term recurrence, and mortality. As for secondary outcomes, compared with the OG group, longer operative time was required for patients in the LG group (MD = 58.80 min, 95% CI = [45.80, 71.81], P < 0.001), but there were less intraoperative blood loss (MD = − 54.93 ml, 95% CI = [− 81.60, − 28.26], P < 0.001), less analgesic administration (frequency: MD = − 1.73, 95% CI = [− 2.21, − 1.24], P < 0.001; duration: MD = − 1.26 days, 95% CI = [− 1.40, − 1.12], P < 0.001), shorter hospital stay (MD = − 1.37 days, 95% CI = [− 2.05, − 0.70], P < 0.001), shorter time to first flatus (MD = − 0.58 days, 95% CI = [− 0.79, − 0.37], P < 0.001), ambulation (MD = − 0.50 days, 95% CI = [− 0.90, − 0.09], P = 0.02) and oral intake (MD = − 0.64 days, 95% CI = [− 1.24, − 0.03], P < 0.04), and less total complications (RR = 0.81, 95% CI = [0.71, 0.93], P = 0.003) in the OG group. There was no difference in blood transfusions (number, quantity) between these two groups. Subgroup analysis, sensitivity analysis, and the adjustment of Duval's trim and fill methods for publication bias did not change the conclusions. Conclusion:LG was comparable to OG in the primary outcomes and had some advantages in secondary outcomes for gastric cancer patients.LG is superior to OG for gastric cancer patients.

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Port Site Metastasis after Surgery for Renal Cell Carcinoma: Harbinger of Future Metastasis

Cited by 46 publications

References 28 publications

Port site recurrence after laparoscopic radical nephrectomy: a case report

Port site recurrence after laparoscopic radical nephrectomy: a case report

Comparison of laparoscopic versus open gastrectomy for advanced gastric cancer: an updated meta-analysis

Laparoscopic versus open gastrectomy for gastric cancer

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