Laparoscopic port‐site metastases in patients with gynecological malignancies

. Objective: The purpose of this study is to review all reported cases of laparoscopic port‐site metastases in patients with gynecological malignancies. Potential etiologies as well as options for prevention are discussed. Methods: We searched the Medline database for English‐language articles presenting raw data on laparoscopic port‐site metastases in patients with gynecological malignancies. Results: We found 31 articles describing port‐site metastases in 58 patients. Forty patients had low malignant potential (seven patients) or invasive ovarian carcinoma (33 patients). The median age of these patients was 50 years (range: 22–79), and 83% had advanced (stage III or IV) disease. Seventy‐one percent of the patients (24 of 34) had ascites, and 97% (29 of 30) had carcinomatosis. Seventy‐five percent of the laparoscopic procedures in this group were performed for diagnosis. Median time to diagnosis of port‐site metastases was 17 days (range: 4–730). Seventy‐one percent of port‐site recurrences (15 of 21) were isolated to a tissue‐manipulating port. Twelve patients had port‐site metastases after laparoscopy for cervical cancer. The median age was 44 years (range: 31–74). Eighty percent of cases were squamous cell carcinoma. In 75% of the patients, laparoscopy was performed for therapeutic purposes. The median time to diagnosis of port‐site metastases was 5 months (range: 1.5–19). Four patients had port‐site metastases after laparoscopy for uterine cancer. The median age was 63 years (range: 56–72). The median time to diagnosis of metastases was 13.5 months (range: 6–21). Half of the recurrences were in the tissue‐manipulating port. Port‐site metastases after laparoscopy were reported for one patient each with a diagnosis of fallopian tube carcinoma and vaginal carcinoma. Conclusions: Laparoscopic port‐site metastases are a potential complication of laparoscopy in patients with gynecological malignancies, even in patients with early‐stage disease.