The role of omental biopsy in endometrial cancer staging

Freij, Mazen; Burbos, Nikolaos; Mukhopadhyay, Debjani; Lonsdale, Ray; Crocker, Simon G.; Nieto, Joaquín J.

doi:10.1007/s10397-009-0476-4

Cited by 7 publications

(7 citation statements)

References 12 publications

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“…Peritoneal cytology is performed at the provider's discretion, although it was taken out of the surgical staging system in 2009, and it has been hypothesized that positive cytology sometimes results from uterine manipulation, especially in minimally invasive surgery. Omentectomy is usually included for clear cell, serous, and sometimes carcinosarcoma histologies given an increased risk of advanced‐stage disease at diagnosis and relatively low morbidity with the procedure, although the risk of microscopic involvement in the absence of visible macroscopic disease is low …”

Section: Therapy‐surgerymentioning

confidence: 99%

Current recommendations and recent progress in endometrial cancer

Brooks

Fleming

Lastra

et al. 2019

CA A Cancer J Clinicians

414

372

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Endometrial cancer is the most common gynecologic cancer in the United States, and its incidence is rising. Although there have been significant recent advances in our understanding of endometrial cancer biology, many aspects of treatment remain mired in controversy, including the role of surgical lymph node assessment and the selection of patients for adjuvant radiation or chemotherapy. For the subset of women with microsatellite‐instable, metastatic disease, anti– programmed cell death protein 1 immunotherapy (pembrolizumab) is now approved by the US Food and Drug Administration, and numerous trials are attempting to build on this early success.

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Section: Therapy‐surgerymentioning

confidence: 99%

Current recommendations and recent progress in endometrial cancer

Brooks

Fleming

Lastra

et al. 2019

CA A Cancer J Clinicians

414

372

View full text Add to dashboard Cite

show abstract

“…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: 72%

“…Omental spread was thought to occur as a result of peritoneal seeding and regional lymphatics (11). On the other hand, the omentum is most probably a different region for metastases of endometrial tumor cells compared to other regions in the body.…”

Section: Discussionmentioning

confidence: 99%

“…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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The use of MRI for selecting patients with endometrial cancer and significant co-morbidities for vaginal hysterectomy

Freij

Saleh

Rawlins

et al. 2010

Arch Gynecol Obstet

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The risk of adnexal metastasis is less than 1% in clinically early stage disease and highly unlikely if MRI suggests that the disease is confined to the inner half of the myometrium and low-grade disease. MRI has a high specificity and negative predictive value in endometrial cancer staging with reduced sensitivity of detecting cervical, adnexal and lymphatic spread. We suggest that vaginal hysterectomy might be a safe alternative to laparotomy in the treatment of radiological early stage disease in medically compromised elderly patients. The possibility of converting a vaginal approach to an abdominal route should be always taken into consideration.

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The role of omental biopsy in endometrial cancer staging

Cited by 7 publications

References 12 publications

Current recommendations and recent progress in endometrial cancer

Current recommendations and recent progress in endometrial cancer

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

The use of MRI for selecting patients with endometrial cancer and significant co-morbidities for vaginal hysterectomy

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