Omental Micrometastasis in Endometrial Cancer

Abstract

<b><i>Introduction:</i></b> Although there are several reports on omentum metastasis, limited studies have evaluated omental micrometastases, particularly isolated microscopic metastases in endometrial cancer (EC). We performed this study to assess the frequency of omental micrometastasis in EC, especially when the omentum is the only site of extrauterine spread. <b><i>Methods:</i></b> A retrospective study was conducted to assess cases of EC with an omental sample during primary surgical treatment for EC at the Gynecological Oncology Unit, Uludag University Hospital, Bursa, Turkey, between January 2005 and May 2018. <b><i>Results:</i></b> In total, 435 patients fulfilled the inclusion criteria, which comprised a complete surgical staging. The prevalence of omental metastases was 5.3% (<i>n</i> = 23), regardless of the subtype or clinical stage. Omental micrometastasis was detected in four cases (17.4%). In half of these patients, the omentum was the only site of disease outside the uterus, with an estimated 0.46% of isolated omental involvement. The grade of the endometrioid tumor was found to be statistically correlated with omental metastases (<i>p</i> = 0.01). There was a significant correlation between omental metastasis and positive peritoneal cytology, as well as adnexal involvement (<i>p</i> = 0.001 and <i>p</i> = 0.03, respectively). <b><i>Conclusion:</i></b> We recommend omentectomy routinely in serous EC. In addition, we suggest selective omentectomy in patients with EC who have concomitant adnexal involvement or grade 3 tumors.

Case Report: Ductal Breast Cancer with Endometrial Metastases

“…In carcinosarcoma, residual disease (P = 0.004) and depth of myometrial invasion (P = 0.017) were found to be predictors of omental metastasis on multivariate analysis [4]. In 3 other studies including both endometrioid and non-endometrioid clinical stage I endometrial cancer patients who underwent total or infracolic omentectomy, risk factors for omental metastasis were grade, cytology, adnexal involvement, depth of myometrial invasion and lymph node involvement [17][18][19].…”

Oncologic safety of laparoscopic surgery for women with apparent early‐stage uterine serous carcinoma: A multi‐institutional retrospective cohort study

“…The prognostic value of systemic lymphadenectomy for early‐stage USC still needs more exploration. The reported incidence of microscopic omental metastases in apparent early‐stage disease was up to 17%, and many studies had justified the adoption of omentectomy in USC 39,40 . Given the high risk of recurrence of USC, postoperative adjuvant radiotherapy and chemotherapy were favored 6–8 .…”

“…The reported incidence of microscopic omental metastases in apparent early-stage disease was up to 17%, and many studies had justified the adoption of omentectomy in USC. 39,40 Given the high risk of recurrence of USC, postoperative adjuvant radiotherapy and chemotherapy were favored. [6][7][8] The employment of adjuvant radiation and chemotherapy could improve the long-term survival of patients with early-stage USC.…”

Recurrence of Adult Granulosa Cell Tumor in the Greater Omentum 11 Years after Surgery

“…Recurrence sites vary, and the pelvis, ovary, mesentery, appendix, liver, and omentum have been reported [ 7 ]. Predicting recurrence and detecting metastatic sites are difficult [ 13 , 14 ]. Recently, micrometastasis of ovarian cancer to the omentum has been studied; however, omentectomy is controversial [ 14 , 15 ].…”

“…Predicting recurrence and detecting metastatic sites are difficult [ 13 , 14 ]. Recently, micrometastasis of ovarian cancer to the omentum has been studied; however, omentectomy is controversial [ 14 , 15 ].…”