The role of omentectomy and random peritoneal biopsies as part of comprehensive surgical staging in apparent early-stage epithelial ovarian cancer.
BACKGROUND
Comprehensive surgical staging plays an important role in apparent early-stage epithelial ovarian cancer (eEOC). However, few studies have evaluated how often upstaging occurs solely as a result of microscopic metastases identified from omentectomy and random peritoneal biopsies. The purpose of this study was to evaluate the significance of omentectomy and random peritoneal biopsies for normal-appearing tissues in eEOC.


METHODS
A retrospective study was performed of patients with eEOC [International Federation of Gynecology and Obstetrics (FIGO) Stages I-IIIA] between 1991 and 2010. The demographic characteristics, surgical findings, and pathologic variables were analyzed.


RESULTS
In total, 324 patients were included in the study. Of 127 patients who underwent random peritoneal biopsies, 6 (4.7 %) were upstaged to IIB or IIC based solely on pelvic peritoneal biopsy findings and 3 (2.4 %) were upstaged to IIIA based on abdominal peritoneal biopsy findings. Of 256 patients who underwent omentectomy, 7 (2.7 %) were upstaged to IIIA based on microscopic metastases identified in the normal-appearing omentum. Following routine omentectomy and random peritoneal biopsies, only one patient in our cohort experienced a change in her adjuvant treatment recommendation.


CONCLUSIONS
Although the rate of upstaging based on routine omentectomy and random peritoneal biopsies is not negligible, there is a low chance that the treatment plan will be altered to include chemotherapy after surgery as a result of the occult microscopic metastases identified.
Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.
Jung-Yun
JY
Lee
Hee Seung
HS
Kim
Hyun Hoon
HH
Chung
Jae Weon
JW
Kim
Noh Hyun
NH
Park
Yong-Sang
YS
Song
D018262:Adenocarcinoma, Clear Cell / Q000473:pathology* / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D018284:Cystadenocarcinoma, Serous / Q000473:pathology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009852:Omentum / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010537:Peritoneum / Q000601:surgery*; D011379:Prognosis; D055815:Young Adult