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864 Abdominal wall metastasis from endometrial cancer associated with peritoneal involvement: radical or palliative cytoreductive surgery?
  1. Alessio Vagliasindi1,
  2. Francesca Sanseverino2,
  3. Battistino Puppio3,
  4. Greta Di Stefano3,
  5. Anna Maria Bochicchio4,
  6. Antonella Prudente4,
  7. Raffaele Ardito4,
  8. Grazia Lazzari5,
  9. Luciana Rago5,
  10. Ilaria Benevento5,
  11. Manuela Botte6,
  12. Aldo Cammarota6,
  13. Maria Imma Lancellotti6 and
  14. Giuseppe Comerci7
  1. 1Oncological Center IRCCS CROB, Rionero In Vulture (pz), Italy
  2. 2Oncological Center IRCCS CROB. Gynecological Surgery, Rionero In Vulture (pz), Italy
  3. 3Oncological Center IRCCS CROB. Abdominal Oncological Surgery, Rionero In Vulture (pz), Italy
  4. 4Oncological Center IRCCS CROB. Unit of Oncology, Rionero In Vulture (pz), Italy
  5. 5Oncological Center IRCCS CROB. Unit of Radiotherapy, Rionero In Vulture (pz), Italy
  6. 6Oncological Center IRCCS CROB. Unit of Radiology, Rionero In Vulture (pz), Italy
  7. 7Unit of Gynecological Oncology. S.Maria delle Croci Hospital. AUSL della Romagna., Ravenna., Italy

Abstract

Introduction/Background Endometrial cancer (EC) is characterized by different routes of spread:

- vaginal;

- lymphatic or hematogenous;

- retrograde through the fallopian tubes into the abdominal cavity.

AWR from EC is an uncommon event.

AWR is due to:

- hematogenous spread to the site of surgical incision;

- seeding of neoplastic cells after direct contact between the tumor and the surgical wound (AWR after laparotomic surgical procedures);

- the aerosol effect’ of pneumoperitoneum in laparoscopic procedures (AWR in laparoscopic port-sites after minimally-invasive surgical procedures).

Methodology A 81 years old patient presented AWR (size: 12 cm) from EC. She had been treated by laparoscopic hysterectomy and bilateral salpingo-oophorectomy 18 months earlier for pT1b G2 endometrioid cancer with angio-lymphathic invasion and peritoneal washing free from tumoral cells.

The patient had received external adjuvant and vaginal RT.

Results The patient underwent a CC0 cytoreductive surgery : wide full thickness resection of AWR together with omentectomy and small bowel resection, owing to the presence of 2 further peritoneal recurrences; AW reconstruction was performed by biologic mesh. The central AWR resection involved the lower portion of both rectus abdominis muscles together with umbilicus.

The postoperative course was uneventful. The pathological examination of all the surgical specimens confirmed the diagnosis of EC recurrences ER+, radically removed.

No adjuvant chemotherapy was performed.

The patient was recurrence free for 18 months and died 19 months later owing to a SARS COV 2 infection.

Conclusion The rates of AWR are 0.11%, 0.20%, and 0.57% after open, laparoscopic, and robotically-assisted surgery respectively (p=0.5) *

AWR may be related to uterine perforation and difficult uterine extraction during minimally-invasive surgery *.

Although patients with non-isolated AWR had significantly ( p=0.04) worse overall survival*, however a CCO cytoreductive surgery may have a favorable impact on cancer related survival.

Bogani G et al. Anticancer Res 2015;35:6097–104.

Disclosures The authors have no relevant disclosures to report.

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