Port-site metastases after open laparoscopy: a study in 173 patients with advanced ovarian carcinoma

Abstract

Open laparoscopy was used to diagnose advanced ovarian cancer. Patients with a pelvic mass and an omental cake and/or large-volume ascites were selected for open laparoscopy. One hundred and seventy-three patients with stage III or IV ovarian carcinoma underwent diagnostic open laparoscopy. Seventy-one patients underwent complete excision of port sites at the time of debulking surgery. Thirty (17%) patients developed port-site metastases. However, only 8 (5%) of these port-site metastases were clinically diagnosed, while 22 out of 71 (31%) with complete port-site excision were diagnosed on pathologic examination. There was no significant relationship between the development of port-site metastases and median time to primary chemotherapy or surgery, the presence of ascites, or stage IV disease. All port-site metastases disappeared during primary therapy, and none of the patients developed a second relapse in one of their port sites. We observed a high rate of port-site metastases after laparoscopy in patients with advanced ovarian carcinoma. However, prognosis was not worse in this group of patients. Laparoscopy is a convenient technique to diagnose advanced ovarian carcinoma, to exclude other primary tumors, and to refer patients to a tertiary center.