Background. Laparoscopy in patients with intra-abdominal malignancy remains
controversial. This study evaluates the incidence of tumor recurrence at t
he Port site after laparoscopy in patients with intraabdominal malignancy.
Methods. The medical records of all patients with nongynecologic malignanci
es who underwent laparoscopic procedures between May 1, 1990, and June 30 1
996, at the University of Texas M.D. Anderson Cancer Center were reviewed.
Data on extent of tumor, histologic findings, primary location, procedures
performed and complications were recorded.
Results. During this time, 533 patients with known intra-abdominal malignan
cies underwent laparoscopy. Mean follow-up time was 13.2 +/- 0.5 months (ra
nge 1 to 71 months; median 10.6 months). Four recurrences at the port site
were identified (0.8%). Three of these patients had advanced intra-abdomina
l disease at the time of laparoscopy; I patient without advanced disease at
the time of laparoscopy had a recurrence at the Port site as the only site
of recurrent disease (0.19%). The incidence of port site recurrences among
patients with advanced intra-abdominal disease at the time of laparoscopy
(3/71) was significantly greater than the risk of development of a recurren
ce at the Port site among patients without advanced intra-abdominal disease
at the time of laparoscopy (1/462; P < .0003, by chi-square analysis).
Conclusion. Recurrence at the port site is very rare. When implantation at
the port site does occur; it is most commonly associated with advanced intr
a-abdominal disease.