Isolated Port Site Metastases in Carcinoma Gallbladder: Does it Represent Better Prognosis?

Port site metastasis (PSM) is a known sequela of laparoscopic cholecystectomy in carcinoma gallbladder. While they are associated with poor prognosis, isolated PSM may represent a subset with better outcomes. We conducted a clinical audit of 33 cases of PSMs treated over a 6-year period. This included 26 cases of isolated PSM and 7 cases of PSM with systemic metastases. The mean time interval between index surgery and appearance of PSM was longer in the patients with isolated PSM (33.11 vs 25.5 months, p = 0.041). Isolated PSMs were treated with surgery and chemotherapy while the others were treated with palliative chemotherapy only. Two out of 27 cases (7 %) of isolated PSM had disease progression during therapy while 3 out of the 6 cases (50 %) of PSM with other sites of recurrences had disease progression while on treatment. Time to disease progression was significant more in cases of isolated PSM (17.14 vs 7.66 months, p = 0.034). The mean survival time too was significantly more in these cases (25.33 vs 15.66 months, p = 0.015). Isolated PSMs in case of gallbladder cancer may represent a distinct disease entity. Aggressive surgical management in addition to systemic chemotherapy may result in a reasonable survival advantage.