Primary XXXX of the abdominal wall--a systematic review of the literature to establish optimal surgical management.

@entity43 @entity1 @entity5 @entity177 @entity1358 @entity3 @entity204
Primary @entity43 of the abdominal wall (AW-OCCC) is an extremely rare occurrence. Therefore, data on the prognosis and treatment regime remain limited. OBJECTIVES: The aim of the study was to provide an evidence-based review of the available case reports to establish optimal surgical management. MATERIAL AND METHODS: A literature search according to PRISMA guidelines was performed using PubMed database (from 01.01.1990 to 31.12.2013) with the terms: " @entity1358 " and "abdominal wall". A total of 17 case reports on 18 @entity1 with full text available were identified. RESULTS: All AW-OCCC's appeared after previous laparotomy for gynecological reasons, with cesarean section as the predominant intervention (15/18, 83%). Median age was 46 years (range 37-56) and median time elapsed between the initial laparotomy and the @entity5 was 19 years (range 9-30). Data on the course of the disease were available for 17 cases. The overall median follow-up was 11 months (range 1-60). No cases of metastatic spread to the ovaries or the intraperitoneal cavity were observed. Eight @entity1 experienced recurrence (8/17, 47.1%). Metastatic lymph nodes appeared in 6 of the 8 relapsed @entity1 and local recurrence in the remaining 2 subjects. There were 4 fatal cases (4/17, 23.5%), including 3 with @entity5 spread. The @entity1 with @entity177 (recurrence or @entity204 ) more frequently developed lymph node @entity3 than the curable cases (p=0.002). CONCLUSIONS: Radical resection of the @entity5 with concomitant pelvic lymph nodes dissection seems to be the most suitable surgical approach. The need for comprehensive intraperitoneal surgical staging for @entity43 is questionable.
