Journal of Cancer Research and Clinical Oncology

, Volume 134, Issue 10, pp 1067–1070 | Cite as

The role of omentectomy during the surgical staging in patients with clinical stage I endometrioid adenocarcinoma

Original Paper

Abstract

Objective

The aim of this study was to evaluate whether omentectomy should be a routine part of staging surgery in endometrioid adenocarcinoma.

Methods

A retrospective study was performed on 65 patients who were primarily treated by total abdominal hysterectomy, salpingo-oophorectomy, bilateral pelvic and para-aortic lymphadenectomy, infracolic omentectomy and peritoneal cytology for clinical stage I endometrial carcinoma between January 2002 and December 2005. Data on 65 patients who had been diagnosed with clinical stage I endometrial carcinoma were reviewed. Associations in the data obtained, pelvic and para-aortic lymph node status, depth of myometrial invasion, grade, vascular invasion, adnexal involvement, positive peritoneal cytology, lymph node metastasis, cervical stromal invasion, and tumor size, were investigated. The Chi-square (χ2) test was used for statistical analysis. Multivariate analysis was performed with logistic regression analyses.

Results

Four (6.2%) of 65 patients had omental metastasis, which was microscopic in two patients. As for extrauterine spread, the positivity rate of lymph node metastases was 10/65 (15.38%), peritoneal cytology was 7/65 (10.76%), and adnexal metastases was 10/65 (15.38%). Of those patients with omental metastasis, 2/10(20%) had positive nodes, 2/10(20%) had adnexal metastases, and 3/7(42.8%) had positive peritoneal cytologic findings. These four patients with omental metastasis had significantly higher rates of positive cytology (P = 0.003). Multivariate analysis revealed omental metastasis (P = 0.002; OR 46.5, CI 95% 3.899–554.575) to be significantly associated with positive peritoneal cytology

Conclusions

We conclude that despite the presence of normal-appearing omentum, omentectomy should be performed as a component of surgical staging in the presence of positive peritoneal cytology.

Keywords

Endometrioid adenocarcinoma Omentectomy Surgical staging 

References

  1. Chan JK, Loizzi V, Youssef M et al (2003) Significance of comprehensive surgical staging in noninvasive papillary serous carcinoma of the endometrium. Gynecol Oncol 90:181–188PubMedCrossRefGoogle Scholar
  2. Chen SS (1985) Extrauterine spread in endometrial carcinoma clinically confined to the uterus. Gynecol Oncol 21:23–31PubMedCrossRefGoogle Scholar
  3. Chen SS, Spiegel G (1991) Stage I endometrial carcinoma. Role of omental biopsy and omentectomy. J Reprod Med 36:627–629PubMedGoogle Scholar
  4. Dilek S, Dilek U, Dede M, Deveci MS, Yenen MC (2006) The role of omentectomy and appendectomy during the surgical staging of clinical stage I endometrial cancer. Int J Gynecol Cancer 16:795–798PubMedCrossRefGoogle Scholar
  5. Fujiwara H, Saga Y, Takahashi K, Ohwada M, Enomoto A, Konno R, Tanaka A, Suzuki M (2008) Omental metastases in clinical stage I endometrioid adenocarcinoma. Int J Gynecol Cancer 18:165–167PubMedCrossRefGoogle Scholar
  6. Gehring PA, Van Le L, Fowler WC (2003) The role of omentectomy during the surgical staging of uterine serous carcinoma. Int J Gynecol Cancer 13:212–215CrossRefGoogle Scholar
  7. Marino BD, Burke TW, Tornos C, Chuang L, Mitchell MF, Tortolero-Luna G, Morris M, Gershenson DM (1995) Staging laarotomy for endometrial carcinoma: assessment of peritoneal spread. Gynecol Oncol 56:34–38PubMedCrossRefGoogle Scholar
  8. Morrow CP, Bundy BN, Kurman RJ, Creasman WT, Heller PB (1991) Relationship between surgical–pathological risk factors and outcome in clinical stages I and II carcinoma of the endometrium. A Gynecologic Oncology Group Study. Gynecol Oncol 40:55–65PubMedCrossRefGoogle Scholar
  9. News FIGO (1989) Corpus cancer staging. Int J Gynecol Obstet 28:189–193CrossRefGoogle Scholar
  10. Nieto JJ, Gornall R, Toms E, Clarkson S, Hogston P, Woolas RP (2002) Influence of omental biopsy on adjuvant treatment field in clinical stage I endometrial carcinoma. Br J Obstet Gynaecol 109:576–578Google Scholar
  11. Ozols RF, Rubin SC, Thomas G (1997) Epithelial ovarian cancer. In: Hoskins WJ, Perez CA, young RC (eds) Principles and practice of gynecologic oncology, 2nd edn. Lippincott–Raven, Philadelphia, pp 919–986Google Scholar
  12. Saygili U, Kavaz S, Altunyurt S, Uslu T, Koyuncuoglu M, Erten O (2001) Omentectomy, peritoneal biopsy, and appendectomy in patients with clinical stage I endometrial carcinoma. Int J Gynecol Cancer 11:471–474PubMedCrossRefGoogle Scholar
  13. Sutton GP (1990) The significance of positive peritoneal cytology in endometrial cancer. Oncology 4:21–26PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.Department of GynecologyAnkara Oncology Education and Research HospitalÇankaya/AnkaraTurkey
  2. 2.Department of PathologyAnkara Oncology Education and Research HospitalAnkaraTurkey

Personalised recommendations