Incidence of incisional recurrence after thoracoscopy

Background: Incisional recurrence after thoracoscopic surgery has been reported infrequently. In recent years, several reports of port-site recurrence after laparoscopic oncologic procedures have been published. This study evaluates the incidence of incisional recurrence among patients with intrathoracic malignancy after diagnostic and therapeutic thoracoscopy. Methods: The medical records of all patients with intrathoracic malignancies who underwent thoracoscopic procedures between 1992 and 1998 at Chang Gung Memorial Hospital Linkou Medical Center were reviewed. Information includes preoperative tumor status, thoracoscopic findings, primary tumor location, tumor pathology, procedures performed, and periciperative complications were recorded. Results: A total of 1,069 patients with known intrathoracic malignancies underwent thoracoscopy. The mean follow-up time was 17.1 months (range, 1-68 months). Two recurrences at the incision were identified (0.19%). Both patients with incision-site recurrence had advanced intrathoracic disease at the time of thoracoscopy. The one patient had a malignant pleural effusion (T4), and the other had diffuse pleural metastasis. Conclusion: The incidence of incisional recurrence after thoracoscopic oncologic surgery is very low. When recurrence occurs at the incision, it is associated most commonly with advanced intrathoracic disease. Additional patients and a longer follow-up evaluation are required, however, to confirm this observation.