Port site metastases after minimally invasive resection for colorectal cancer: A retrospective study of 13 patients

Kwong, Mei Li M.; Sampah, Maame Efua; Bello, Brian L.; Sugarbaker, Paul H.

doi:10.1016/j.suronc.2019.02.008

Cited by 13 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several pathophysiological mechanisms have been proposed explaining the development of PSR, such as hematogenous spread, direct contamination and implantation of the trocar site, multiple effects of the pneumoperitoneum, effects of carbon dioxide used for insufflation and local immune reactions, and surgical technique [21]. Although randomized controlled trials show that open versus minimally invasive colorectal cancer surgery have equivalent survival [22], PSR continue to be reported [23, 24]. Also, for gynecological tumors the effect of PSR on prognosis is conflicting, as not all patients with PSR carried a worse prognosis [25].…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Partial Cystectomy versus Open Partial Cystectomy for Patients with Urachal Cancer

et al. 2022

View full text Add to dashboard Cite

Introduction: Localized urachal cancer (UrC) can be treated with an open partial cystectomy (OPC) with en bloc resection of the urachal remnant and umbilicus. Robot-assisted partial cystectomy (RAPC) is an alternative approach, of which its safety and efficacy for UrC remains to be determined. In the present study, we analyze these outcomes after RAPC, compared with OPC. Methods: We retrospectively evaluated 55 cN0M0 UrC patients who underwent RAPC (n = 8) or OPC (n = 47) between 1994 and 2020. Overall survival (OS) and recurrence-free survival (RFS) were assessed using Kaplan-Meier methods. Positive surgical margins (PSM), port-site recurrences (PSR) versus wound recurrences were compared. Complications were recorded using the Clavien-Dindo classification. Results: Median follow-up was 40 months (IQR 21–95). Two-year OS and RFS for RAPC were 73% (95% confidence intervals (CI); 56–89 months) and 60% (95% CI; 42–78 months), respectively, versus 90% (95% CI; 85–95 months) and 66% (95% CI; 59–73 months) for OPC. PSM rate was 13% in both groups. PSR occurred in 2/8 (25%) patients after RAPC. No wound recurrences occurred after OPC. Postoperative complications occurred in 2/8 (25%) patients after RAPC, versus 5/47 (11%) after OPC (p = 0.27). Conclusion: Both RAPC and OPC seem feasible surgical modalities to treat localized UrC with comparable survival. The PSR rate of 25% after RAPC should prompt us to be cautious to recommend RAPC as no such recurrences were seen using OPC.

show abstract

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Partial Cystectomy versus Open Partial Cystectomy for Patients with Urachal Cancer

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Consistent with our research, several large meta-analysis and original research had confirmed this conclusion ( 4 , 8 , 61 , 62 ). However, after literature search, there were still several reports that laparoscopic surgery could increase the peritoneal and trocar recurrence rate of T4 colon cancer patients ( 63 – 67 ). Wang et al reported that laparoscopic colectomy for T4 colon cancer had a higher peritoneal recurrence rate than open surgery (18.1 vs. 10.6 percent; RR 1.56, 1.23–1.99; P = 0.0003) ( 66 ).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic vs. open colectomy for T4 colon cancer: A meta-analysis and trial sequential analysis of prospective observational studies

et al. 2022

View full text Add to dashboard Cite

BackgroundTo evaluate short- and long-term outcomes of laparoscopic colectomy (LC) vs. open colectomy (OC) in patients with T4 colon cancer.MethodsThree authors independently searched PubMed, Web of Science, Embase, Cochrane Library, and Clinicaltrials.gov for articles before June 3, 2022 to compare the clinical outcomes of T4 colon cancer patients undergoing LC or OC.ResultsThis meta-analysis included 7 articles with 1,635 cases. Compared with OC, LC had lesser blood loss, lesser perioperative transfusion, lesser complications, lesser wound infection, and shorter length of hospital stay. Moreover, there was no significant difference between the two groups in terms of 5-year overall survival (5y OS), and 5-year disease-free survival (5y DFS), R0 resection rate, positive resection margin, lymph nodes harvested ≥12, and recurrence. Trial Sequential Analysis (TSA) results suggested that the potential advantages of LC on perioperative transfusion and the comparable oncological outcomes in terms of 5y OS, 5y DFS, lymph nodes harvested ≥12, and R0 resection rate was reliable and no need of further study.ConclusionsLaparoscopic surgery is safe and feasible in T4 colon cancer in terms of short- and long-term outcomes. TSA results suggested that future studies were not required to evaluate the 5y OS, 5y DFS, R0 resection rate, positive resection margin status, lymph nodes harvested ≥12 and perioperative transfusion differences between LC and OC.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022297792.

show abstract

“…Early on a lack of precise technology with colon cancer resection resulted in an unacceptable high incidence of port site metastases. As these patients were studied it became evident that port site cancer nodules, almost always, were an indication of widespread peritoneal metastases and guarded prognosis [5]. After refinements in laparoscopic techniques, Nelson et al reported in a randomized controlled trial that survival the laparoscopic colon resection compared to survival after open colon resection [4].…”

Section: Discussionmentioning

confidence: 99%

“…Inadvertent spread of microscopic disease by some or many steps of the laparoscopic procedure could result in inadequate containment of cancer. Although studies show in randomized controlled trials that open and minimally invasive colon cancer resection have equivalent survival [4], port site metastases continue to be reported [5]. In this case report we follow the clinical course of a patient with early ovarian cancer who has a laparoscopic resection of her primary disease at an academic cancer center.…”

Section: Introductionmentioning

confidence: 99%

Port site recurrence, an unintended consequence of laparoscopic resection of ovarian cancer. A case report

Sugarbaker

2019

International Journal of Surgery Case Reports

Self Cite

View full text Add to dashboard Cite

Highlights The goal of cancer surgery is complete removal and absolute containment of the malignant process. Laparoscopy performed with cancer cells within the peritoneal space may cause cancer progression within trochar sites. This unintended adverse consequence of laparoscopy may be reduced by limiting trochar sites to the midline. Prospective data regarding the incidence of trochar site disease is not available but it does continue to occur.

show abstract

Port site metastases after minimally invasive resection for colorectal cancer: A retrospective study of 13 patients

Cited by 13 publications

References 29 publications

Robot-Assisted Partial Cystectomy versus Open Partial Cystectomy for Patients with Urachal Cancer

Robot-Assisted Partial Cystectomy versus Open Partial Cystectomy for Patients with Urachal Cancer

Laparoscopic vs. open colectomy for T4 colon cancer: A meta-analysis and trial sequential analysis of prospective observational studies

Port site recurrence, an unintended consequence of laparoscopic resection of ovarian cancer. A case report

Contact Info

Product

Resources

About