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

ObjectiveTo evaluate the incidence and possible predictors associated with port-site metastases following robotic surgery. DesignProspective study. SettingUniversity Hospital. PopulationWomen with gynecological cancer. MethodsThe occurrence of port-site metastases in the first 475 women undergoing robotic surgery for gynecological cancer was reviewed. Main outcome measuresRate of port-site metastases. ResultsA 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 6months (range 2-19months). Six of the nine women (67%) have died and their median time of survival from recurrence was 4months (range 2-16months). ConclusionIn 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.