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

• Published in: Surgical oncology 2019-06, Vol.29, p.20-24
• Main Authors: Kwong, Mei Li M., Sampah, Maame Efua S., Bello, Brian L., Sugarbaker, Paul H.
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Antigens; Cancer; Cancer therapies; Carcinoembryonic antigen; Chemotherapy; Colon; Colon cancer; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Cytoreduction; Female; Females; Follow-Up Studies; HIPEC (heated intraperitoneal chemotherapy); Histology; Humans; Incidence; Laparoscopic; Laparoscopy; Laparoscopy - adverse effects; Male; Males; Medical records; Metastases; Metastasis; Middle Aged; Minimally Invasive Surgical Procedures - adverse effects; Morbidity; Pain; Patients; Peritoneal Neoplasms - epidemiology; Peritoneal Neoplasms - secondary; Peritoneum; Port site metastasis; Postoperative Complications; Prognosis; Retrospective Studies; Robotic; Robotic surgery; Robotics; Studies; Surgery; Survival Rate; Tumors; Young Adult
• ISSN: 0960-7404; 1879-3320
• DOI: 10.1016/j.suronc.2019.02.008

Minimally invasive surgeries are increasingly being performed for primary colon cancer resections since laparoscopic and robotic surgeries have less post-operative pain, shorter length of hospitalization, less morbidity, improved patient satisfaction and equivalent R0 resection rates compared to laparotomy. To analyze characteristics of patients who developed port site metastases after minimally invasive colectomy, a retrospective case series of a single institution from 2004 to 2017 was performed. The study included patients who had a minimally invasive resection of the primary colon cancer and subsequent cytoreduction and heated intraperitoneal chemotherapy (CRS/HIPEC) for peritoneal metastases. Patient characteristics, histology, pathology, prior treatments, time between surgeries, carcinoembryonic antigen (CEA) levels and survival were reviewed. There were 123 patients who had CRS/HIPEC and 13 of them had a history of laparoscopic or robotic colectomy followed by the development of port site disease. Four were females, nine were males. Median age was 48 years (range, 19–64). Eleven of 13 primary colon cancers were T3 or T4. Ten of 13 patients had no clinical evidence of peritoneal metastases at the time of initial resection. All 13 patients had metastatic deposits at port sites that were confirmed histopathologically at the time of CRS/HIPEC. Port site metastases were present concomitantly with peritoneal metastases in 13 patients. An advanced T-stage of disease occurred in 85% of patients. Port site metastases do occur after minimally invasive colon resection. •Thirteen patients had port site metastases from minimally invasive resections.•Ten of these 13 patients had no prior evidence of peritoneal metastases.•Eleven of these 13 patients had T3 or T4 cancer.