title: What is the importance of omental metastasis in patients with endometrial cancer?
abstract: OBJECTIVE
  To identify surgico-pathologic factors, survival, and the factors determining survival in patients with omental metastasis from endometrial cancer.
  
  
  METHODS
  Patients with endometrial cancer operated on between 1993-2012 in our hospital and who had omental metastases were included. Patients with either uterine sarcoma or synchronous tumors were excluded.
  
  
  RESULTS
  Omentectomy was performed in 811 patients with endometrial cancer, and omental metastasis was found in 48 (5.9%) patients. Tumor type was endometrioid cancer in 26 patients. Omental metastasis was macroscopic and microscopic in 60% and 40% of the patients, respectively. Total omentectomy increased the chance of detection of the microscopic metastases. Among the patients with omental metastasis, 68.8% had positive peritoneal cytology, 66.7% had adnexal involvement, 60.5% had metastases in the lymph nodes, 47.9% had cervical involvement, and 29.2% had serosal involvement; 43.8% of these patients had intra-abdominal spread beyond the omentum, adnexa, and peritoneal cytology. Two-year disease-free survival (DFS) was 28.2%, and 2-y overall survival (OS) was 40%. The depth of myometrial invasion, grade, cytology, and status of pelvic lymph nodes affected 2-y DFS, while cervical invasion and cytology affected 2-y OS.
  
  
  CONCLUSIONS
  Omental metastasis in endometrial cancer means poor prognosis, and two-thirds of these patients are lost at the end of the second year. Although total omentectomy increases the chance of the detection of micrometastases, its effect on survival is controversial. New treatment modalities are necessary in this patient group.
authors.affiliation: Department of Gynecologic Oncology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Turan
authors.affiliation: Department of Gynecologic Oncology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Işın
authors.initials: I
authors.lastname: Ureyen
authors.affiliation: Department of Gynecologic Oncology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Karalök
authors.affiliation: Department of Gynecologic Oncology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Taşçı
authors.affiliation: Department of Gynecologic Oncology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Ilgın
authors.affiliation: Department of Gynecology and Obstetrics, Ankara Atatürk Education and Research Hospital, Ankara, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Keskin
authors.affiliation: Department of Gynecologic Oncology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: M Faruk
authors.initials: MF
authors.lastname: Kose
authors.affiliation: Department of Gynecologic Oncology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Tulunay
keywords: Endometrial cancer; omental metastases; survival