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Rate of Port-Site Metastasis Is Uncommon in Patients Undergoing Robotic Surgery for Gynecological Malignancies
  1. Bih T. Ndofor, MD*,
  2. Pamela T. Soliman, MD,
  3. Kathleen M. Schmeler, MD,
  4. Alpa M. Nick, MD,
  5. Michael Frumovitz, MD and
  6. Pedro T. Ramirez, MD
  1. *Department of Obstetrics and Gynecology, Baylor College of Medicine; and
  2. Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
  1. Address correspondence and reprint requests to Pedro T. Ramirez, MD, Department of Gynecologic Oncology, Unit 1362, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030. E-mail: peramire{at}mdanderson.org.

Abstract

Objective: To describe the rate of port-site metastasis in patients who underwent robotic surgery for suspected gynecological malignancy.

Methods: Using a prospective database, we identified all patients who underwent robotic surgery performed by the Gynecologic Oncology service at 1 institution between December 2006 and March 2010. Records of patients with confirmed malignancy were reviewed for clinicopathological data and information about port-site metastasis.

Results: One hundred eighty-one patients met the inclusion criteria. The median age was 55.4 years (range, 19-82 years), and the median body mass index was 29.6 kg/m2 (range, 17.9-70.7 kg/m2). Port-site metastases were detected in 2 patients (1.1%) at 3 weeks (patient 1) and 11 months (patient 2) after surgery. Patient 1 underwent surgery for an adnexal mass, and pathological examination revealed gallbladder adenocarcinoma metastatic to the ovary. She had a recurrence in the right lateral abdominal wall robotic trocar site with concurrent metastases in the gallbladder fossa and liver. Patient 2 was diagnosed with adenocarcinoma of unclear (cervical vs endometrial) origin. Imaging showed metastases in pelvic and para-aortic lymph nodes. She underwent laparoscopy and was found intraoperatively to have gross disease on the right ovary. The patient underwent right salpingo-oophorectomy and chemoradiation. She had residual disease in the cervix and subsequently underwent robotic hysterectomy and left salpingo-oophorectomy. Pathological examination revealed endometrial cancer. She had a recurrence at the transumbilical trocar site concurrent with retroperitoneal lymphadenopathy and carcinomatosis. There were no cases of isolated port-site metastasis.

Conclusions: The rate of port-site metastasis after robotic surgery in women with gynecological cancer is low and similar to the rate for laparoscopic procedures.

  • Robotic
  • Laparoscopy
  • Port-site metastasis/recurrence
  • Ovarian cancer
  • Cervical cancer
  • Uterine cancer

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Footnotes

  • Disclosure: The authors declare no conflicts of interest.

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