Topical treatment with oxaliplatin for the prevention of port-site metastases in laparoscopic surgery for colorectal cancer.
BACKGROUND
The development of port-site metastases following laparoscopic resection of various malignancies continues to be a disturbing issue for laparoscopic surgeons. Previous studies revealed promising results with oxaliplatin, a third-generation platinum compound, as a first-line treatment in advanced colorectal cancer. This study evaluates the effect of topical application of oxaliplatin on the development of port-site metastases in an experimental murine model.


METHODS
Nineteen female BDIX rats (immunocompetent, 6 weeks old) underwent a sham laparoscopic operation after 1 x 10(7) viable rat colon carcinoma viable cells (LMCR) had been injected into their peritoneal cavities. Three trocars (1 central camera port and 2 additional lateral ports) were introduced into the abdomen, and a pneumoperitoneum was created with carbon dioxide. Ten minutes after LMCR, cells were injected into the peritoneal cavity, the 2 lateral trocars were removed and carbon dioxide insufflation was maintained for an additional 5 minutes to allow for tumor cell seeding. Oxaliplatin (0.198 mg/kg) was then topically applied to 1 trocar site intramuscularly, while the other site was left untreated. One week later, the animals were euthanized, and the port sites were histologically examined for evidence of metastases.


RESULTS
The rate of tumor implantation at the muscle layer in control sites was 68% (13/19) compared with 37% (7/19) at oxaliplatin-treated sites (P = 0.1). Also, no significant differences were detected in port-site metastasis rates in other untreated layers of the abdominal wall.


CONCLUSIONS
Intramuscular topical application of oxaliplatin may not decrease the incidence of port-site metastasis in a syngeneic animal model of colon cancer. Nevertheless, we can see the tendency of declination. Further studies are needed to better determine its possible therapeutic role in high-risk humans undergoing laparoscopic resection of colorectal malignancies.
Tai
Yun-Sheng
YS
Department of Surgery, New York Presbyterian Hospital, Weill-Cornell College of Medicine, New York, New York 10021, USA.
Abente
Federico Cuenca
FC
Assalia
Ahmad
A
Ueda
Kazuki
K
Gagner
Michel
M
D000287:Administration, Topical; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D010535:Laparoscopy / Q000009:adverse effects*; D009366:Neoplasm Seeding; D009944:Organoplatinum Compounds / Q000008:administration & dosage*; D000077150:Oxaliplatin; D051381:Rats
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin