Port-site metastases following robot-assisted laparoscopic surgery for gynecological malignancies.

Lönnerfors, Celine; Bossmar, Thomas; Persson, Jan

OBJECTIVE To evaluate the incidence and possible predictors associated with port-site metastases following robotic surgery. DESIGN Prospective study. SETTING University Hospital. POPULATION Women with gynecological cancer. METHODS The occurrence of port-site metastases in the first 475 women undergoing robotic surgery for gynecological cancer was reviewed. MAIN OUTCOME MEASURES Rate of port-site metastases. RESULTS A port-site metastasis was detected in nine of 475 women (1.9%). Eight women had either an unexpected locally advanced disease or lymph-node metastases at the time of surgery. All nine women received postoperative adjuvant therapy. Women with ≥ stage III endometrial cancer and women with node positive cervical cancer had a significantly higher risk of developing a port-site metastasis, as did women with high-risk histology endometrial cancer. Port-site metastases were four times more likely to occur in a specimen-retrieval port. One (0.2%) isolated port-site metastasis was detected. The median time to occurrence of a port-site metastasis was 6 months (range 2-19 months). Six of the nine women (67%) have died and their median time of survival from recurrence was 4 months (range 2-16 months). CONCLUSION In women with gynecological cancer, the incidence of port-site metastases following robotic surgery was 1.9%. High-risk histology and/or advanced stage of disease at surgery seem to be contributing factors.