Prognostic Significance of omental Disease and the Role of Omental Sampling in Patients With Uterine Carcinosarcoma

Ross, Malcolm S.; Elishaev, Esther; Berger, Jessica; Kelley, Joseph L.; Taylor, S.E.

doi:10.1097/igc.0000000000001176

Cited by 15 publications

(15 citation statements)

References 19 publications

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“…Identification of these cases will allow inclusion of patients with advanced stage disease into clinical trials. 175 Positive peritoneal cytology correlates with poor prognostic factors and poor survival; however, it is not part of FIGO staging and unclear if this should influence treatment decisions. [176][177][178] Recommendations ► Standard surgery is total hysterectomy with bilateral salpingooophorectomy without vaginal cuff resection (II, A).…”

Section: Standard Surgical Proceduresmentioning

confidence: 99%

ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma

Concin

Matías‐Guiu

Vergote

et al. 2020

Int J Gynecol Cancer

983

1,229

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A European consensus conference on endometrial carcinoma was held in 2014 to produce multi-disciplinary evidence-based guidelines on selected questions. Given the large body of literature on the management of endometrial carcinoma published since 2014, the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly decided to update these evidence-based guidelines and to cover new topics in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide.

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Section: Standard Surgical Proceduresmentioning

confidence: 99%

ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma

Concin

Matías‐Guiu

Vergote

et al. 2020

Int J Gynecol Cancer

983

1,229

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“…In early-stage disease, surgery represents the milestone of treatment, and includes total hysterectomy, bilateral salpingo-oophorectomy, pelvic and aortic lymphadenectomy, and peritoneal biopsies (Baekelandt and Castiglione 2009; Denschlag and Ulrich 2018) www.nccng uidel ines.gov (2020); even though omentectomy or omental al sampling are not formally recommended, these procedures often carried out probably because microscopic involvement has been shown to account for 35% of omental disease, and thus could be missed (Ross et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Role of minimally invasive surgery versus open approach in patients with early-stage uterine carcinosarcomas: a retrospective multicentric study

Corrado

Ciccarone

Cosentino

et al. 2020

J Cancer Res Clin Oncol

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Objective The aim of this retrospective study was to compare surgical and survival outcome in only patients with early-stage UCSs managed by laparotomic surgery (LPT) versus minimally invasive surgery (MIS). Methods Data were retrospectively collected in four Italian different institutions. Inclusion criteria were UCS diagnosis confirmed by the definitive histological examination, and stage I or II according to the FIGO staging system. Results Between August 2000 and March 2019, the data relative to 170 patients bearing UCSs were collected: of these, 95 were defined as early-stage disease (stage I–II) based on the histological report at the primary surgery, and thus were included in this study. Forty-four patients were managed by LPT, and 51 patients were managed by MIS. The operative time was lower in the MIS group versus the LPT group (p value 0.021); the median estimated blood loss was less in the MIS group compared to the median of LPT group (p value < 0.0001). The length of hospital stay days was shorter in the MIS patients (p value < 0.0001). Overall, there were eight (8.4%) post-operative complications; of these, seven were recorded in the LPT group versus one in the MIS group (p value 0.023). There was no difference in the disease-free survival (DFS) and overall survival (OS) between the two groups. Conclusion There was no difference of oncologic outcome between the two approaches, in face of a more favourable peri-operative and post-operative profile in the MIS group.

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“…Our study showed that omental metastases were a risk factor for decreased PFS and OS. Ross et al revealed that omental disease had a significant impact on survival (median OS 11.4 vs 128.7 months for those who did and did not have omental disease, respectively; P < 0.001) [24]. Second, adjuvant chemotherapy and targeted therapy might help improve the survival of patients with advanced endometrial cancer [25].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, omentectomy may reduce recurrence. Moreover, omentectomy is not a complicated procedure, and it seldom results in severe postoperative complications [24,28,29]. However, based on the existing data, it should be noted that the survival benefit of adding omentectomy to the treatment for USC when the omentum is normal in appearance is still uncertain [30].…”

Section: Discussionmentioning

confidence: 99%

The role of omentectomy in the surgical treatment of uterine serous carcinoma

Chen

Guo

Tan

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective The aims of this study were to assess the role of omentectomy in the staging of uterine serous carcinoma (USC) and to evaluate its impact on patient outcomes. Study design Patients diagnosed with USC at the First Affiliated Hospital of Sun Yat-sen University of China were retrospectively reviewed. The clinicopathological characteristics and survival data of 187 patients were analyzed. Risk factors for omental metastasis were evaluated. Kaplan–Meier survival curves were used to compare survival status and the presence of omental metastasis. Results We found that 35 of 187 patients (18.7%) had omental metastases. Omental metastasis was significantly associated with adnexal involvement (40.0% vs 19.1%, P = 0.008, OR 2.828, 95% CI 1.286–6.218). Multivariate analysis showed that in addition to lymph node metastases and suboptimal surgery, omental metastasis in USC remained an independent predictor of decreased PFS and OS (PFS, HR 1.48, 95% CI 1.14–4.63, P = 0.024; OS, HR 1.39, 95% CI 1.04–3.60, P = 0.043). Conclusions The incidence of omental metastasis is not low in patients with USC. Visual assessment and omental biopsy may be insufficient for recognizing occult metastases. Omentectomy should be part of the staging surgery in USC patients because it provides additional information about survival. Prospective studies are needed to confirm these results.

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Prognostic Significance of omental Disease and the Role of Omental Sampling in Patients With Uterine Carcinosarcoma

Cited by 15 publications

References 19 publications

ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma

ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma

Role of minimally invasive surgery versus open approach in patients with early-stage uterine carcinosarcomas: a retrospective multicentric study

The role of omentectomy in the surgical treatment of uterine serous carcinoma

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