The role of omentectomy during the surgical staging in patients with clinical stage I endometrioid adenocarcinoma.
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.
Metindir
Jale
J
Department of Gynecology, Ankara Oncology Education and Research Hospital, Ahmet Mithat Efendi Sok No: 58/11, Cankaya/Ankara, Turkey. jmetindir@ttmail.com
Dilek
Gülay Bilir
GB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology* / Q000601:surgery*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D009852:Omentum / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies