1087 IS PORT SITE METASTASIS A RESULT OF HEMATOGENOUS SEEDINGS?

Abstract

You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111087 IS PORT SITE METASTASIS A RESULT OF HEMATOGENOUS SEEDINGS? Anil Mandhani, Vikas Agarwal, and Rakesh Kapoor Anil MandhaniAnil Mandhani Lucknow, India More articles by this author , Vikas AgarwalVikas Agarwal Lucknow, India More articles by this author , and Rakesh KapoorRakesh Kapoor Lucknow, India More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1125AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Oncological adequacy of laparoscopic procedure at times been challenged due to the occurrence of port site metastasis. Reasons attributed to the occurrence of port site metastasis have been described to be related to laparoscopy. Here in we propose a hypothesis of occurrence of port site metastasis due to systemic involvement. METHODS Six cases of port site metastasis, 4 cases following laparoscopic radical nephrectomy for localized renal cell carcinoma (RCC) in 136, 1 after laparoscopic radical prostatectomy done in 2 and 1 after laparoscopic partial cystectomy for tumor at the dome of the bladder done in 2 were studied for the pattern of disease recurrence in follow up. All the cases were done during the period between Dec' 99 and Dec' 2008. One case of metastatic RCC who had repeated intramuscular injection at bilateral gluteal region for pain management was also studied for the pattern of recurrence. General precautions to prevent port site metastasis were taken in all. RESULTS All 6 cases of port site metastasis had advanced disease and recurrences at other sites too, i.e. peritoneum, abdominal wall, omentum, boney pelvis and lung. None of the patients had isolated port site metastasis. Four of 6 had metastasis within a year of initial laparoscopic surgery and rest 2 patients with RCC presented at 2 and 5 years each following lap radical nephrectomy. One patient of RCC with systemic disease, who did not have any intervention but repeated intramuscular injection of analgesics, had bilateral gluteal masses, which were confirmed to be clear cell RCC on fine needle aspiration cytology. CONCLUSIONS Port site metastasis did not develop in isolation; instead all were associated with simultaneous metastasis at other sites too. There could be a likely existence of circulating tumor cells at the time of surgical trauma of penetrating nature i.e. port site or injection site, which manifest in some patients depending upon the immune response. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e437 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anil Mandhani Lucknow, India More articles by this author Vikas Agarwal Lucknow, India More articles by this author Rakesh Kapoor Lucknow, India More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...