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Yu N, Zhou T, Sun H, Fu P, Liu R. Port Site Metastasis After Minimally Invasive Surgery in Gynecologic Malignancies: Two Case Reports and a Review of the Literature. Int J Womens Health 2023; 15:579-588. [PMID: 37077283 PMCID: PMC10106789 DOI: 10.2147/ijwh.s406488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/06/2023] [Indexed: 04/21/2023] Open
Abstract
Port site metastasis (PSM) is considered an uncommon and rare complication in gynecologic malignancies with unclear treatment recommendations or guidelines. Thus, we report the treatment strategies and outcomes of two cases of PSMs following gynecologic malignancies and a review of the literature to provide much information about the most frequent sites of PSMs and the incidence of PSMs in different gynecological tumors. A 57-year-old woman underwent laparoscopic radical surgery for right ovarian serous carcinoma in June 2016 followed by postoperative chemotherapy. Because PSMs were present near the port site of the bilateral iliac fossa, the tumors were completely removed on August 4, 2020, and the patient received chemotherapy. She has shown no signs of relapse. During the same period, a 39-year-old woman underwent laparoscopic type II radical hysterectomy for endometrial adenocarcinoma involving the endometrium and cervix on May 4, 2014, without adjuvant treatment. In July 2020, a subcutaneous mass under her abdominal incision was removed, and chemotherapy plus radiotherapy was administered. Metastasis was found in the left lung in September 2022, but there was no abnormality in the abdominal incision. We showed the two cases of PSMs, reviewed articles to provide some new insights about the incidences of PSMs in the gynecologic tumors, and discussed the proper preventive strategies.
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Affiliation(s)
- Nan Yu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Ting Zhou
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Haiying Sun
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Peiying Fu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Ronghua Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Correspondence: Ronghua Liu, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Anv., Wuhan, Hubei, 430030, People’s Republic of China, Tel +86-27-63639807, Fax +86 (27) 83663078, Email
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Trocar Site Recurrences Following Laparoscopic and Robotic Resection of Gynecologic Malignancies. J Minim Invasive Gynecol 2017; 24:683. [PMID: 28189775 DOI: 10.1016/j.jmig.2016.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 12/28/2016] [Indexed: 11/20/2022]
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Baptiste CD, Buckley de Meritens A, Jones NL, Chatterjee Paer S, Tergas AI, Hou JY, Wright JD, Burke WM. Port Site Metastases: A Survey of the Society of Gynecologic Oncology and Commentary on the Clinical Workup and Management of Port Site Metastases. J Minim Invasive Gynecol 2017; 24:592-598. [PMID: 28126400 DOI: 10.1016/j.jmig.2017.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 01/14/2017] [Accepted: 01/17/2017] [Indexed: 01/08/2023]
Abstract
STUDY OBJECTIVE Laparoscopic port site metastases (PSMs) have an incidence of .5% to 2%. The management of an isolated PSM (iPSM), without evidence of recurrence elsewhere, remains unclear. The aim of this study was to elucidate practices regarding iPSMs. DESIGN A 23-item survey was created using commercially available survey software. Over the course of January 2016 the survey was e-mailed to the members of the Society of Gynecologic Oncology with 2 follow-up reminder e-mails. (Canadian Task Force classification III.) SETTING: Online survey. MEASUREMENTS AND MAIN RESULTS Of the 709 surveys sent, 132 were returned. Providers practicing for <5 years saw fewer PSMs and those who performed more minimally invasive surgeries (MISs) saw more PSMs. Comparing providers who have or have not seen PSMs, no differences in pneumoinsufflation pressure, the mode of delivery of the specimen, the use of local anesthesia at port site incisions, or the method of deflation were seen. If an iPSM was suspected, most providers indicated they would obtain imaging (computed tomography, 51%, or positron emission tomography/computed tomography, 43%) followed by an interventional radiology-guided biopsy (29%) or resection of the mass. Tendency for treatment is to surgically resect the lesion followed by adjuvant therapy. CONCLUSION After controlling for time in practice, we did not find a strong risk factor for iPSMs other than performing >75% of oncologic surgeries by MIS. Most respondents performed imaging when suspecting iPSMs and use systemic adjuvant therapy after confirming iPSMs.
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Affiliation(s)
- Caitlin D Baptiste
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; Columbia University College of Physicians and Surgeons, New York Presbyterian, New York, New York.
| | - Alexandre Buckley de Meritens
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, New York, New York; Columbia University College of Physicians and Surgeons, New York Presbyterian, New York, New York
| | - Nathaniel L Jones
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, New York, New York; Columbia University College of Physicians and Surgeons, New York Presbyterian, New York, New York
| | - Sudeshna Chatterjee Paer
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, New York, New York; Columbia University College of Physicians and Surgeons, New York Presbyterian, New York, New York
| | - Ana I Tergas
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, New York, New York; Columbia University College of Physicians and Surgeons, New York Presbyterian, New York, New York
| | - June Y Hou
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, New York, New York; Columbia University College of Physicians and Surgeons, New York Presbyterian, New York, New York
| | - Jason D Wright
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, New York, New York; Columbia University College of Physicians and Surgeons, New York Presbyterian, New York, New York
| | - William M Burke
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, New York, New York; Columbia University College of Physicians and Surgeons, New York Presbyterian, New York, New York
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