Omentectomy, peritoneal biopsy and appendectomy in patients with clinical stage I endometrial carcinoma

Saygılı, Uğur; Kavaz, S.; Altunyurt, Sabahattin; Uslu, Turhan; Koyuncuoğlu, Meral; Erten, Oktay

doi:10.1046/j.1525-1438.2001.01065.x

Cited by 27 publications

(27 citation statements)

References 15 publications

(23 reference statements)

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“…It was 9.1% in our previous study evaluating mixed-type endometrial carcinoma (19). Similarly, the ratio of omental metastasis in endometrial cancer was reported between 2.4% and 8.3% (8)(9)(10)(11)(12)(13)(14)(15). Nevertheless, in these studies, omentectomy was performed as infracolic omentectomy or omental biopsy.…”

Section: Discussionmentioning

confidence: 73%

“…Nevertheless, in these studies, omentectomy was performed as infracolic omentectomy or omental biopsy. Furthermore, 11%-71.4% of the reported omental metastases were micrometastases (8)(9)(10)(11)(12)(13)(14)(15)20). It is not possible to say whether there were microscopic metastases or not in the remaining omentum after subtotal omentectomy.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the information obtained from this procedure may help in the management. Omental metastasis is observed in 2.4%-8.3% of patients with endometrium cancer (8)(9)(10)(11)(12)(13)(14)(15). Nevertheless, it is not clear who to perform omentectomy on and whether omentectomy should be performed for patients without intra-abdominal disease and without high risk factors for metastasis and recurrence.…”

Section: Introductionmentioning

confidence: 99%

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What is the importance of omental metastasis in patients with endometrial cancer?

Turan

Üreyen

Karalök

et al. 2014

J Turkish German Gynecol Assoc

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Objective: To identify surgico-pathologic factors, survival, and the factors determining survival in patients with omental metastasis from endometrial cancer. Material and Methods:Patients with endometrial cancer operated on between 1993-2012 in our hospital and who had omental metastases were included. Patients with either uterine sarcoma or synchronous tumors were excluded.Results: Omentectomy was performed in 811 patients with endometrial cancer, and omental metastasis was found in 48 (5.9%) patients.Tumor type was endometrioid cancer in 26 patients. Omental metastasis was macroscopic and microscopic in 60% and 40% of the patients, respectively. Total omentectomy increased the chance of detection of the microscopic metastases. Among the patients with omental metastasis, 68.8% had positive peritoneal cytology, 66.7% had adnexal involvement, 60.5% had metastases in the lymph nodes, 47.9% had cervical involvement, and 29.2% had serosal involvement; 43.8% of these patients had intra-abdominal spread beyond the omentum, adnexa, and peritoneal cytology. Two-year disease-free survival (DFS) was 28.2%, and 2-y overall survival (OS) was 40%. The depth of myometrial invasion, grade, cytology, and status of pelvic lymph nodes affected 2-y DFS, while cervical invasion and cytology affected 2-y OS. Conclusion:Omental metastasis in endometrial cancer means poor prognosis, and two-thirds of these patients are lost at the end of the second year. Although total omentectomy increases the chance of the detection of micrometastases, its effect on survival is controversial. New treatment modalities are necessary in this patient group. (J Turk Ger Gynecol Assoc 2014; 15: 164-72) Key words: Endometrial cancer, omental metastases, survival Received: 03 June, 2014 Accepted: 25 July, 2014 What is the importance of omental metastasis in patients with endometrial cancer? Abstract of patients involving all stage IV patients. Patients without other intra-abdominal metastases and patients with microscopic omental metastases were included in these studies. The reports, except the studies mentioned above, were presented as very small case series or case reports. The patients with omental metastases were not analyzed with regard to surgico-pathologic characteristics and survival, and the factors determining survival have not been identified sufficiently in endometrial cancer. In this study, the determination of surgico-pathologic factors, survival, and the factors determining survival in patients with omental metastases from endometrial cancer is aimed. Material and Methods Study PopulationThe records and pathologic reports of patients with endometrial cancer who were operated in our clinic between 1993 and 2012 were analyzed retrospectively. The patients with omental metastasis were included. Patients with uterine sarcoma, endometrioid carcinoma involving a sarcoma component, or synchronous tumors were excluded. The data related to demographic characteristics, intraoperative findings, debulking status, surgico-pathologic results, pat...

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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What is the importance of omental metastasis in patients with endometrial cancer?

Turan

Üreyen

Karalök

et al. 2014

J Turkish German Gynecol Assoc

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“…© 2011 National Comprehensive Cancer Network). This is due to the propensity for omental involvement (Sherman et al 1992;Saygili et al 2001) and spread to the peritoneal surfaces (Geisler et al 1999;Chan et al 2003) in women diagnosed with papillary serous or clear cell endometrial cancer. Maximum cytoreductive effort is recommended in the presence of extrauterine disease due to the associated survival advantage (Olawaiye and Boruta 2009).…”

Section: Papillary Serous and Clear Cell Carcinomamentioning

confidence: 99%

Treatment Strategies and Prognosis of Endometrial Cancer

Garg¹,

Mutch²

2012

Cancer of the Uterine Endometrium - Advances and Controversies

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“…Evaluation of the omentum is limited to visual inspection during the surgical staging procedure for patients with endometrioid carcinoma. However, occult metastasis on the omentum and peritoneal surfaces has been reported in patients with clinical stage I disease [5,6,7]. Patients with omental metastasis not associated with positive regional lymph nodes are classified as stage IV even when the tumor is limited to the uterine corpus.…”

Section: Introductionmentioning

confidence: 99%

Should Omentectomy Be a Part of Surgical Staging in Patients with Endometrioid Adenocarcinoma of the Uterine Corpus?

Ülker

Tunca²,

Numanoğlu³

et al. 2013

Gynecol Obstet Invest

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Background: The purpose of the study was to determine the prevalence of omental metastasis in endometrioid adenocarcinoma and to correlate risk variables with this spread. Methods: A retrospective analysis of patients with endometrioid adenocarcinoma who underwent omentectomy in addition to staging laparotomy was performed. Results: Omental metastases were noted in 11 of the 322 patients with endometrioid adenocarcinoma (3.4%). Multivariate analyses showed that there was a significant correlation between omental metastasis and positive peritoneal cytology, adnexal involvement, and grade 3 tumor (p = 0.028, p = 0.001, and p = 0.01, respectively). There was no statistical relationship between omental metastasis and lymphovascular space involvement, deep myometrial invasion, and lymph node metastasis (p = 0.087, p = 0.97, and p = 0.92, respectively). Conclusion: Grade 3 endometrioid adenocarcinomas, especially those that are complicated by deep myometrial invasion, have a pattern of intra-abdominal spread similar to more aggressive endometrial cancers, with frequent involvement of the omentum. Overall, we conclude that 37.5% (3/8) of patients who had a grade 3 tumor and omental metastasis stage IV disease would have been missed if a staging operation similar to that employed for ovarian cancer had not been performed.

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Omentectomy, peritoneal biopsy and appendectomy in patients with clinical stage I endometrial carcinoma

Cited by 27 publications

References 15 publications

What is the importance of omental metastasis in patients with endometrial cancer?

What is the importance of omental metastasis in patients with endometrial cancer?

Treatment Strategies and Prognosis of Endometrial Cancer

Should Omentectomy Be a Part of Surgical Staging in Patients with Endometrioid Adenocarcinoma of the Uterine Corpus?

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