title: Prognostic Impact of Port-Site Metastasis After Diagnostic Laparoscopy for Epithelial Ovarian Cancer.
abstract: This study was designed to evaluate the prevalence, morbidity, and prognostic impact of port-site metastasis (PSM) in patients with epithelial ovarian cancer (EOC) undergoing laparoscopy before subsequent primary debulking surgery (PDS).
  
  
  
  All consecutive patients treated between 2000 and 2014, who had a laparoscopy followed by PDS, were extracted from our prospectively maintained database. All patients with histological examination of port-sites were included in this unicentric exploratory analysis.
  
  
  
  A total of 250 (25.5 %) of 982 patients with EOC underwent laparoscopy before PDS. Port-site resection was performed in those 214 (85.6 %) patients in whom a complete or almost complete resection with residuals ≤1 cm was achieved. Median interval between laparoscopy and PDS was 25 days. PSM was detected in 100 of 214 patients (46.7 %). Risk factors for PSM were higher tumor stage (odds ratio [OR] 13.5, 95 % confidence interval [CI] 2.9-62.0, p = 0.04), positive lymph node status (OR 3.0, 95 % CI 1.3-6.7, p = 0.009), and ascites >500 mL (OR 3.9, 95 % CI 1.5-10.0, p = 0.005). Wound healing disorders and postoperative morbidity were significantly higher in patients with PSM (Clavien-Dindo Classification grade 3-5: 41.0 vs. 14.9 %, p < 0.001). However, multivariate Cox-regression models did not identify PSM as independent prognostic factor.
  
  
  
  The prevalence of PSM after laparoscopy in EOC patients is considerably high. PSM had no impact on survival; however, PSM were associated with more postoperative complications and a higher surgical treatment burden. This should be balanced with the expected benefit when laparoscopy is considered for the management of EOC.
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany. b.ataseven@kliniken-essen-mitte.de.
authors.forename: Beyhan
authors.initials: B
authors.lastname: Ataseven
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany.|Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center Vienna - Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Grimm
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Harter
authors.affiliation: Kliniken Essen Mitte, Center for Pathology, Essen, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Heikaus
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Heitz
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Traut
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany.
authors.forename: Sonia
authors.initials: S
authors.lastname: Prader
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany.
authors.forename: Annett
authors.initials: A
authors.lastname: Kahl
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schneider
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kurzeder
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung, Essen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: du Bois
mesh_terms: D000368:Aged; D001201:Ascites / Q000150:complications; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D009375:Neoplasms, Glandular and Epithelial / Q000556:secondary* / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery*; D016066:Pleural Effusion, Malignant / Q000209:etiology; D012307:Risk Factors; D000072836:Surgical Wound / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D014945:Wound Healing