Advertisement

Indian Journal of Surgical Oncology

, Volume 9, Issue 3, pp 427–431 | Cite as

Resection of Isolated Port Site Metastasis in Gall Bladder Cancers—Careful Selection and Perioperative Systemic Therapy May Improve Outcomes

  • Vivek Agarwala
  • Anant Ramaswamy
  • Sanyo Dsouza
  • Nikhil Pande
  • Mahesh Goel
  • Shraddha Patkar
  • Vikas Ostwal
Original Article
  • 24 Downloads

Abstract

Excision of port site (PSE) for patients having undergone laparoscopic cholecystectomy (LC) is not a standard recommendation. We retrospectively evaluated a cohort of patients with isolated PSM without any prior cancer-directed therapy who were assessed for resection between March 2012 and July 2016 at Tata Memorial Hospital, Mumbai. Eleven of a total 13 patients underwent wide excision for PSM in the given time period. Upfront resection was undertaken in six patients while seven patients received neoadjuvant chemotherapy (NACT) and two received neoadjuvant chemo radiotherapy (NACTRT) prior to attempted resection. With the median follow-up of 22 months, post PSM disease-free survival (DFS) was 20 months (95% CI 15–24 months) and overall survival (OS) was 37 months (95% CI 22–51 months). Careful selection along with an aggressive management strategy may be a step forward in the treatment of patients with isolated PSM.

Keywords

Gall bladder cancer (GBC) Port site metastasis Port site excision Palliative chemotherapy 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Mhatre SS, Nagrani RT, Budukh A, Chiplunkar S, Badwe R, Patil P, Laversanne M, Rajaraman P, Bray F, Dikshit R (2016) Place of birth and risk of gallbladder cancer in India. Indian J Cancer 53:304–308CrossRefPubMedGoogle Scholar
  2. 2.
    Drouard F, Delamarre J, Capron JP (1991) Cutaneous seeding of gallbladder cancer after laparoscopic cholecystectomy. N Engl J Med 325:1316PubMedGoogle Scholar
  3. 3.
    Paolucci V (2001) Port site recurrences after laparoscopic cholecystectomy. J Hepatobiliary Pancreat Surg 8:535–543CrossRefPubMedGoogle Scholar
  4. 4.
    Berger-Richardson D, Tyler RC, Marina E et al (2017) Trends in port-site metastasis after laparoscopic resection of incidental gallbladder cancer: a systematic review. Surgery 161(3):618–627CrossRefPubMedGoogle Scholar
  5. 5.
    Lundberg O (2000) Port site metastasis after laparoscopic cholecystectomy. Eur J Surg Suppl 11:27–30CrossRefGoogle Scholar
  6. 6.
    Aloia TA, Jarufe N, Javle M et al (2015) Gallbladder cancer: expert consensus statement. HPB (oxford) 17:681–690CrossRefPubMedCentralGoogle Scholar
  7. 7.
    Shoup M, Fong Y (2002) Surgical indications and extent of resection in gallbladder cancer. Surg Onco lClin N Am 11:985–994CrossRefGoogle Scholar
  8. 8.
    Povoski SP, Quellette JR, Chang WW et al (2004) Axillary lymph node metastasis following resection of abdominal wall laparoscopic port site recurrence of gall bladder cancer. J Hepatobiliary Pancreat Surg 11:197–202CrossRefPubMedGoogle Scholar
  9. 9.
    Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Lundberg O, Kristoffersson A (1999) Port site metastasis from gallbladder cancer after laparoscopic cholecystectomy. Results of a Swedish survey and review of published reports. Eur J Surg 165:215–222CrossRefPubMedGoogle Scholar
  11. 11.
    Z’Graggen K, Birrer S, Maurer CA et al (1998) Incidence of port site recurrence after laparoscopic cholecystectomy for preoperatively unsuspected gallbladder carcinoma. Surgery 124:831–838CrossRefPubMedGoogle Scholar
  12. 12.
    Fuks D, Regimbeau JM, Pessaux P et al (2013) Is port site resection necessary in the surgical management of gallbladder cancer? J Visc Surg 150:277–284CrossRefPubMedGoogle Scholar
  13. 13.
    Maker AV, Butte JM, Oxenberg J et al (2012) Is port site resection necessary in the surgical management of gall bladder cancer? Ann Surg Oncol 19:409–417CrossRefPubMedGoogle Scholar
  14. 14.
    Ciulla A, Romeo G, Genova G, Tomasello G, Agnello G, Cstronovo G (2006) Gallbladder carcinoma late metastasis and incisional hernia at umbilical port site after laparoscopic cholecystectomy. G Chir 27:214–216PubMedGoogle Scholar
  15. 15.
    Hu JB, Sun XN, Xu J, He C (2008) Port site and distant metastases of gallbladder cancer after laparoscopic cholecystectomy diagnosed by positron emission tomography. World J Gastroenterol 14:6428–6431CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Hamila F, Letaief R, Khnissi M, Derbel F, Mazhoud J, Ben Ali A, Dahmene Y, Ben Hadj Hamida R (2006) Port site recurrence after laparoscopic cholecystectomy. Tunis Med 84(11):697–700PubMedGoogle Scholar

Copyright information

© Indian Association of Surgical Oncology 2018

Authors and Affiliations

  1. 1.Department of Medical OncologyTata Memorial Centre (TMH)MumbaiIndia
  2. 2.Department of Surgical OncologyTMHMumbaiIndia

Personalised recommendations