The aim of this study was to compare laparoscopic and laparotomic surgical staging in patients with stage I epithelial ovarian cancer in terms of feasibility and safety. A retrospective chart review was undertaken of all patients with apparent stage I epithelial ovarian cancer who underwent laparoscopic (laparoscopy group) or laparotomic (laparotomy group) surgical staging at the Center for Uterine Cancer, National Cancer Center, Korea, between January 2001 and August 2006. During the study period, 19 patients underwent laparotomic surgical staging and 17 patients underwent laparoscopic surgical staging. No cases were converted from laparoscopy to laparotomy. The two groups were similar in terms of age, body mass index, procedures performed, number of lymph nodes retrieved, and operating time. The laparoscopy group had less estimated blood loss (P = 0.001), faster return of bowel movement (P < 0.001), and a shorter postoperative hospital stay (P = 0.002) compared to the laparotomy group. Transfusions were required only in two laparotomy patients, and postoperative complications occurred only in four laparotomy patients. However, two patients with stage IA grade 1 and 2 disease in laparoscopy group had recurrence with one patient dying of disease. The accuracy and adequacy of laparoscopic surgical staging were comparable to laparotomic approach, and the surgical outcomes were more favorable than laparotomic approach. However, the oncologic safety of laparoscopic staging was not certain. This is the first report on the possible hazards of laparoscopic staging in early-stage ovarian cancer. In the absence of a large prospective trial, this technique should be performed cautiously.

Abstract. Park J-Y, Lim MC, Lim SY, Bae J-M, Yoo CW, Seo S-S, Kang S, Park S-Y. Port-site and liver metastases after laparoscopic pelvic and para-aortic lymph node dissection for surgical staging of locally advanced cervical cancer. Int J Gynecol Cancer 2008;18:176-180.Recently, we experienced a case of port-site and liver metastases after 75 cases of laparoscopic transperitoneal pelvic lymph node dissection (PLND) and para-aortic lymph node dissection (PALND) for surgical staging of locally advanced cervical cancer. A 45-year-old-woman with stage IIB cervical adenocarcinoma underwent laparoscopic PLND and PALND for surgical staging. There was no intraperitoneal disease and cervical tumor was not manipulated at the time of laparoscopic surgery. Pathologic examination revealed only one micrometastasis in left internal iliac lymph node (LN), measuring 1 mm, of the 60 pelvic and para-aortic LNs removed. She received concurrent chemoradiation therapy and pelvic mass disappeared completely. One month after the completion of therapy, both lateral and umbilical port-site and liver metastases were detected. We conclude that although cases of port-site metastasis have mostly occurred after extensive disease, the possibility of such complication should be kept in mind at laparoscopy of early cancer and laparoscopy which does not manipulate primary tumor.KEYWORDS: cervical cancer, laparoscopic surgery, port-site metastasis, staging.Laparoscopic surgery for cervical cancer has been associated with less postoperative pain, an early return of bowel function, a shorter period of hospitalization and disability, better cosmetic results, and shorter time interval between operation and adjuvant chemoradiation. Therefore, laparoscopy is being performed with increasing frequency in the management of cervical cancer such as radical hysterectomy with lymph node dissection for treatment of early stage disease and pelvic lymph node dissection (PLND) and paraaortic lymph node dissection (PALND) for surgical staging of locally advanced disease. But, cancer recurrence at the port-site wounds has raised the question as to whether it is a safe oncologic procedure, although it is a very rare complication.Port-site metastases are mostly reported in ovarian cancer but have also been reported in cervical cancer rarely. The first case of port-site metastasis after laparoscopic transperitoneal surgical staging of advanced cervical cancer was reported in 1997(1) and additional six cases were reported since then. So far, only seven cases were reported in the literature as far as we know and we reported the additional case in this article. Recently, we experienced a case of port-site metastasis after 75 cases of laparoscopic PLND and PALND for staging of advanced cervical cancer. Therefore, we present this case with review of the literature. CaseA 45-year-old woman, gravida 2, presented with postcoital bleeding. Physical examination revealed