Dilek S, Dilek U, Dede M, Deveci M S, Yenen M C
Department of Obstetrics and Gynecology, Mersin University, School of Medicine, Mersin, Turkey.
Int J Gynecol Cancer. 2006 Mar-Apr;16(2):795-8. doi: 10.1111/j.1525-1438.2006.00531.x.
Assessment of extrauterine spread is the most important objective of surgical staging in the endometrioid adenocarcinoma of uterine corpus. The role of omentectomy and appendectomy in the staging procedure is unclear. In this study, our objective was to determine whether omentectomy and appendectomy should be a part of the surgical staging in endometrioid adenocarcinoma of uterine corpus. Fifty-one patients who were diagnosed as clinical stage I endometrioid adenocarcinoma of corpus uteri were reviewed. Demographic, clinicopathologic, and surveillance data were collected from hospital charts. Grade, myometrial invasion, cervical and adnexal involvement and positive peritoneal cytology, lymph node and omentum and appendix involvement were recorded. The median age of 51 women was 60.45 years. Median follow-up period was 46.19 months. Microscopic omental involvement was detected in three cases (6%). Two cases (3.9%) of metastasis to appendix were seen. Omentum metastasis was more common in the patient with adnexal involvement, lymph node metastasis, and deep myometrial invasion (P= 0. 014, P= 0. 046, and P= 0. 033, respectively). Median survival was 53 months. We conclude that omentectomy gives additional information about extrauterine spread of tumor without increased operational morbidity and should be performed as a component of surgical staging in the presence of normal appeared omentum.
评估子宫外扩散是子宫内膜样腺癌手术分期的最重要目标。大网膜切除术和阑尾切除术在分期手术中的作用尚不清楚。在本研究中,我们的目的是确定大网膜切除术和阑尾切除术是否应成为子宫内膜样腺癌手术分期的一部分。回顾了51例被诊断为临床I期子宫内膜样腺癌的患者。从医院病历中收集人口统计学、临床病理和监测数据。记录分级、肌层浸润、宫颈和附件受累情况、腹腔细胞学阳性、淋巴结以及大网膜和阑尾受累情况。51名女性的中位年龄为60.45岁。中位随访期为46.19个月。3例(6%)检测到显微镜下大网膜受累。2例(3.9%)出现阑尾转移。大网膜转移在附件受累、淋巴结转移和肌层深层浸润的患者中更常见(分别为P = 0.014、P = 0.046和P = 0.033)。中位生存期为53个月。我们得出结论,大网膜切除术可提供有关肿瘤子宫外扩散的额外信息,且不会增加手术并发症,在大网膜外观正常的情况下应作为手术分期的一部分进行。