Mechanism and Prevention of Port-Site Tumor Recurrence After Laparoscopy in a Murine Model

Abstract

BackgroumVfurpose: Although minimally invasive surgery (MIS) has been broadly applied in patients with cancer of the gastrointestinal tract, the etiology of port-site tumor recurrence (PSR) after laparoscopic cancer surgery remains unclear. The authors report here an analysis of PSR in a model of murine neuroblastoma after laparoscopic tumor biopsy and propose a mechanism for this complication as well as a potential treatment. Metho&; Immature 5-to 7-week old male A/J mice (18-23 g) weresubcutaneouslyinoculated with the minimally immunogenic TBJ-neuroblastoma (TBJ-NB) in the left flank and divided into three treatment groups. The following operations were performed 14 days after tumor inoculation: group 1, additional intraperitoneai or intravenous injection ofTBJ-NB during CO2 pneumoperitoneum; group 2, simulated transperitoneal tumor biopsy using MIS techniques during either CO* pneumoperitoneum or gasless suspension; Group 3, intraperitoneal (IPI or intravenous (IV) administration of cyclophosphamide on postoperative days 0 and 3 to prevent PSR after simulated tumor biopsy during CO* pneumoperitoneum. Resu/fs: In group 1, the incidence of PSR was 0% In the intravenously injected mice versus 63% in mice injected