Omental Biopsy for Surgical Staging of Uterine Serous Carcinoma

Abstract

Omental involvement in USC upstages patients to stage IV disease and traditional risk factors fail to predict extrauterine disease. Although omental sampling does not influence disease progression or survival, a comprehensive intraoperative evaluation of the omentum is advised as most cases have grossly visible lesions.

Uterin seröz karsinom ve uterin berrak hücreli karsinom tanısı alan hastalarda klinikopatolojik özelliklerin ve sağ kalım sonuçlarının karşılaştırılması

“…Additionally, only two of 8 patients had micrometastasis in this study (15). Therefore, the authors concluded that omentectomy as a part of comprehensive surgical staging for UPSC may not be necessary according to these two studies (14,15). However, this study represents that the rate of omental metastasis is consistent with the previous studies, as high as 21-25%, which suggests omentectomy or omental biopsy should be a part of the staging procedure for USC (10,11).…”

“…In this study, 66 out of 106 patients were undergone omentum biopsy (54; 82%) or omentectomy (12; 18%) and they found that only eight women (12%) had omental metastasis. Additionally, only two of 8 patients had micrometastasis in this study (15). Therefore, the authors concluded that omentectomy as a part of comprehensive surgical staging for UPSC may not be necessary according to these two studies (14,15).…”

“…Sixten of the 18 patients had macroscopic metastasis and the remaining two patients had microscopic omental disease. Luz et al (15) designed a study including 106 patients with USC in 2016. In this study, 66 out of 106 patients were undergone omentum biopsy (54; 82%) or omentectomy (12; 18%) and they found that only eight women (12%) had omental metastasis.…”

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

“…The prevalence of omental metastasis in USC ranged from 10 to 17.4% [[12], [13], [14]]. Even in women with noninvasive serous carcinoma limited to the endometrium, the occurrence of omental metastases was as high as 5.1–9.8% (58/591) in clinical stage I nonendometrioid type endometrial cancer [15,16].…”

“…Third, it should be noted that the omentum is a common site of recurrence. Rita Luz reported that the most frequent sites of recurrence or progression in USC were the peritoneum (31%), followed by the omentum (27%), pelvis (18%), lungs (18%), and liver (14%) [13]. Thus, omentectomy may reduce recurrence.…”