title: Isolated port-site metastases after minimally invasive hysterectomy for endometrial cancer: outcomes of patients treated with radiotherapy.
abstract: OBJECTIVE
  The management and prognosis of isolated port-site metastases after laparoscopic surgery for endometrial cancer is poorly understood and rarely described in the literature. We report a series of cases treated with radiotherapy to better characterize outcomes in these patients.
  
  
  METHODS
  We retrospectively reviewed medical records of patients with endometrial cancer who developed isolated port-site metastases and were treated with radiation therapy at MD Anderson Cancer Center from 1996 to 2013. Seven patients met these criteria for whom treatment and outcome data were collected.
  
  
  RESULTS
  The median interval from initial surgery to port-site recurrence was 15 months. Recurrent tumor size varied from 0.5 to 9 cm as measured on axial imaging. Six of the 7 patients underwent surgical resection of the recurrence. All received radiotherapy to a dose of 45 to 66 Gy. At a median follow-up of 2 years from the time of the port-site recurrence, the rate of disease-free survival at 1 and 2 years after the recurrence was 100% and 44%, respectively. The rate of local control and overall survival at 2 years was 100%.
  
  
  CONCLUSIONS
  Isolated port-site metastases in the setting of endometrial cancer are associated with high rates of local control when treated with multimodality therapy including radiotherapy. Long-term disease-free outcomes in some patients suggest the potential for cure and justify aggressive local therapy. The optimal integration of surgery, chemotherapy, and radiation is unknown.
authors: Departments of *Radiation Oncology and †Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Jonathan Douglas
authors: JD
authors: Grant
authors: Amit K
authors: AK
authors: Garg
authors: Ramesh
authors: R
authors: Gopal
authors: Pamela T
authors: PT
authors: Soliman
authors: Anuja
authors: A
authors: Jhingran
authors: Patricia J
authors: PJ
authors: Eifel
authors: Ann H
authors: AH
authors: Klopp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects*; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate