How to prevent the iatrogenic diffusion of gynecological malignant tumors?

An analysis of the causes for iatrogenic diffusion of gynecological malignant tumors during their diagnosis and treatment, through clinical experience and a comprehensive review of both Chinese and international literatures was carried out. When a curettage, hysteroscopy or laparoscopy is performed, an iatrogenic diffusion of malignant tumors can be caused. Therefore this phenomenon needs to be prevented and reduced during the diagnosis and treatment of gynecological malignant tumors, and to improve the curative effect and survival times of tumor patients.

Gynecological tumors; Iatrogenic diffusion; Prevention.

[1] M. Ying, B. Ping: “Iatrogenic implantation”. J. Chin. J. Clin. Oncol., 2008, 35, 117.

[2] Miller C.E.: “Training in minimally invasive surgery - you say you want a revolution”. J. Minim. Invasive Gynecol., 2009, 16, 113. doi: 10.1016/j.jmig.2009.01.001.

[3] Eltabbakh G.H., Shamonki M.I., Moody J.M., Garafano L.L.: “Hysterectomy for obese women with endometrial cancer: laparoscopy or laparotomy?”. Gynecol. Oncol., 2000, 78, 329.

[4] Wang X., Zhang H., Di W., Li W.: “Clinical factors affecting the diagnostic accuracy of assessing dilation and curettage vs frozen section specimens for histologic grade and depth of myometrial invasion in endometrial carcinoma”. Am. J. Obstet. Gynecol., 2009, 201, 194. Epub 2009, Jun. 28.

[5] Canis M., Botchorishvili R., Wattiez A., Pouly J.L., Mage G., Manhes H., Bruhat M.A.: “Cancer and laparoscopy, experimental studies: a review”. Eur. J. Obstet. Gynecol. Reprod. Biol., 2000, 91, 1.

[6] Taner C.E., Oztekin M., Mun S., Sehirali S., Büyüktosun C., Basogul O.: “Borderline ovarian tumors: A study of 100 cases”. ASCO Meeting Abstracts, 2006, 24, 15069.

[7] Desfeux P., Bats A.S., Bensaid C., Chatellier G., Blanc B., Querleu D., Lecuru F.: “Impact of the surgical route on staging and outcome of early borderline ovarian tumors”. Gynecol. Obstet. Fertil., 2007, 35, 193.

[8] Kornblith A.B., Huang H.Q., Walker J.L., Spirtos N.M., Rotmensch J., Cella D.: “Quality of life of patients with endometrial cancer undergoing laparoscopic international federation of gynecology and obstetrics staging compared with laparotomy: A gynecologic oncology group study”. J. Clin. Oncol., 2009, 27, 5337.

[9] Bijen C.B., de Bock G.H., ten Hoor K.A., Nijman H W., Hollema H., Mourits M.J.: “Role of endocervical curettage in the preoperative staging of endometrial carcinoma”. Gynecol. Oncol., 2009, 112, 521.

[10] Oonk M.H., van de Nieuwenhof H.P., de Hullu J.A., van der Zee A.G.: “The role of sentinel node biopsy in gynecological cancer: a review”. Curr. Opin. Oncol., 2009, 21, 425.

[11] Fait V.: “Sentinel node biopsy and possibilities of use in current surgical oncology”. Klin. Onkol., 2008, 21, 5.

[12] Wood N.J., Munot S., Sheridan E., Duffy S.R.: “Does a ‘one-stop’ gynecology screening clinic for women in hereditary nonpolyposis colorectal cancer families have an impact on their psychological morbidity and perception of health?”. Int. J. Gynecol. Cancer, 2008, 18, 279.

[13] Fu Chun, Li Guangyi, Liu Fengying, Lin Qiuhua, Fang Xiaoling: “Influence of laparoscopic surgery of endometrial cancer under CO2 pneumoperitoneum upon implantation and metastasis of cancer cells”. J. J. Central South Univ. (Medical Sciences), 2008, 33, 130. (In Chinese).

[14] Fu Chun, Li Guangyi, Liu Fengying: “Influence of laparoscopic surgery of early cervical cancer under CO2 pneumoperitoneum upon Implantation and metastasis of cancer cells”. J. Chin. J. Clin. Oncol., 2008, 35, 697. (In Chinese)

[15] Ghezzi F., Cromi A., Uccella S., Bergamini V., Tomera S., Franchi M., Bolis P.: “Laparoscopy versus laparotomy for the surgical management of apparent early stage ovarian cancer”. Gynecol. Oncol., 2007, 105, 409.

[16] Park J.Y., Kim D.Y., Suh D.S., Kim J.H., Kim Y.M., Kim Y.T., Nam J.H.: “Comparison of laparoscopy and laparotomy in surgical staging of early stage ovarian and fallopian tubal cancer”. Ann. Surg. Oncol., 2008, 15, 2012.

[17] Heitz F., Ognjenovic D., Harter P., Kommoss S., Ewald-Riegler N., Haberstroh M. et al.: “Abdominal wall metastases in patients with ovarian cancer after laparoscopic surgery: incidence, risk factors, and complications”. Int. J. Gynecol. Cancer, 2010, 20, 41.

[18] Degaard E., Staff A.C., Langebrekke A., Engh V., Onsrud M.: “Surgery of borderline tumors of the ovary: retrospective comparison of short term outcome after laparoscopy or laparotomy”. Acta Obstet. Gynecol. Scand., 2007, 86, 620.

[19] Nowak M., Szpakowski M., Malinowski A., Romanowicz H., Wieczorek A., Szpakowski A. et al.: “Laparoscopy and laparotomy in the operative treatment of ovarian cysts”. Ginekol. Pol., 2000, 71, 1173.

[20] Van Dam P.A., De Cloedt J., Tjalma W.A., Buytaert P., Becquart D., Vergote I.B.: “Trocar implantation metastasis after laparoscopy in patients with advanced ovarian cancer: can the risk be reduced?”. Am. J. Obstet. Gynecol., 1999, 181, 536.

[21] Volz J., Köster S., Spacek Z., Paweletz N.: “The influence of pneumoperitoneum used in laparoscopic surgery on an intraabdominal tumor growth”. Cancer, 1999, 86, 770.

[22] Morice P., Camatte S., Larregain-Fournier D., Thoury A., Duvillard P., Castaigne D.: “Port-site implantation after laparoscopic treatment of borderline ovarian tumors”. Obstet. Gynecol., 2004, 104, 1167.

[23] Liu C.S., Nagarsheth N.P., Nezhat F.R.: “Laparoscopy and ovarian cancer: a paradigm change in the management of ovarian cancer?”. J. Minim. Invasive Gynecol., 2009 16, 250.

[24] Fauvet R., Boccara J., Dufournet C., Poncelet C., Daraï E.: “Laparoscopic management of borderline ovarian tumors: results of a French multicenter study”. Ann. Onc., 16, 403.

[25] Santi A., Kuhn A., Gyr T., Eberhard M., Johann S., Gunthert A.R., Mueller M.D.: “Laparoscopy or laparotomy? A comparison of 240 patients with early-stage endometrial cancer”. Surg. Endosc., 2010, 24, 939.

[26] Ikechebelu J.I., Okeke K.A.: “Improving the safety of room air pneumoperitoneum for diagnostic laparoscopy”. Niger J. Clin. Pract., 2008, 11, 127.

[27] Langmar Z., Szabo I.: “Role of laparoscopy in the treatment of early endometrial cancer”. Orv. Hetil., 2010, 151, 1748.

[28] Tenney M., Walker J.L.: “Role of laparoscopic surgery in the management of endometrial cancer”. J. Natl. Compr. Canc. Netw., 2009, 7, 559.

[29] Zanvettor P.H., Filho D.F., Neves A.R., Amorim M.J., Medeiros S.M., Laranjeiras L.C. et al.: “Laparoscopic surgical staging of locally advanced cervix cancer (IB2 to IVA): initial experience”. Gynecol. Oncol., 2011, 120, 358.