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

J Cancer Res Clin Oncol. 2008 Oct;134(10):1067-70. doi: 10.1007/s00432-008-0389-z. Epub 2008 Apr 2.


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 (chi(2)) 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Endometrioid / pathology*
  • Carcinoma, Endometrioid / surgery*
  • Female
  • Genital Neoplasms, Female / pathology*
  • Genital Neoplasms, Female / surgery*
  • Gynecologic Surgical Procedures
  • Humans
  • Middle Aged
  • Neoplasm Staging / methods
  • Omentum / pathology*
  • Omentum / surgery*
  • Retrospective Studies