Grant Jonathan Douglas, Garg Amit K, Gopal Ramesh, Soliman Pamela T, Jhingran Anuja, Eifel Patricia J, Klopp Ann H
Departments of *Radiation Oncology and †Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Int J Gynecol Cancer. 2015 Jun;25(5):869-74. doi: 10.1097/IGC.0000000000000424.
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.
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.
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%.
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.
对于子宫内膜癌腹腔镜手术后孤立性切口转移灶的管理及预后，目前了解甚少，且文献中鲜有描述。我们报告一系列接受放射治疗的病例，以更好地明确这些患者的治疗结果。
我们回顾性分析了1996年至2013年在MD安德森癌症中心接受放射治疗的发生孤立性切口转移灶的子宫内膜癌患者的病历。7例患者符合这些标准，并收集了其治疗及预后数据。
从初次手术到切口复发的中位间隔时间为15个月。根据轴向影像学测量，复发肿瘤大小在0.5至9厘米之间。7例患者中有6例接受了复发病灶的手术切除。所有患者均接受了45至66 Gy的放射治疗。从切口复发时起中位随访2年，复发后1年和2年的无病生存率分别为100%和44%。2年时的局部控制率和总生存率均为100%。
对于子宫内膜癌患者的孤立性切口转移灶，采用包括放射治疗在内的多模式治疗时，局部控制率较高。部分患者的长期无病生存结果提示有治愈的可能，并证明积极的局部治疗是合理的。手术、化疗和放疗的最佳联合方式尚不清楚。
