Cordeiro Vidal Gloria, Croce Sabrina, Guyon Frédéric, Babin Guillaume, Querleu Denis
Departments of *Surgery and †Pathology, Centre Regional de Lutte Contre le Cancer, Institut Bergonié, Bordeaux, France.
Int J Gynecol Cancer. 2017 Feb;27(2):252-257. doi: 10.1097/IGC.0000000000000832.
The aim of this study was to document the need of including the perigastric area when performing omentectomy in patients with stage III to IV serous epithelial ovarian tumors.
Patients undergoing omentectomy in the setting of surgery for advanced epithelial serous ovarian cancer between February and September 2015 were included. Patients with macroscopic involvement of the perigastric area, nonepithelial serous tumors, and recurrences of ovarian cancer were excluded. The perigastric area was isolated and comprehensively processed for pathological examination.
Twenty-four patients were included. Six patients underwent primary debulking surgery, and 18 patients underwent an interval debulking surgery. The mean number of pathologic blocks in the perigastric area was 24 (range, 8-41). Microscopic involvement of the perigastric omentum area was found in 62.5% of the cases. One patient had a low-grade serous carcinoma, with microscopic involvement of the perigastric area. Among the 23 patients with a high-grade serous carcinoma, 10 (83%) of 12 patients with a gross involvement of the rest of the omentum had a microscopic involvement of the perigastric area. The presence of microscopic disease in the perigastric arcade was found in 4 (36.3%) of 11 patients with a macroscopically normal omentum.
In this study, evidence is given that total omentectomy including the perigastric area is a necessary component of complete cytoreductive surgery in advanced ovarian cancer, whatever the macroscopic appearance of the omentum.
本研究的目的是记录在对Ⅲ至Ⅳ期浆液性上皮性卵巢肿瘤患者进行网膜切除术时，纳入胃周区域的必要性。
纳入2015年2月至9月期间因晚期上皮性浆液性卵巢癌手术而行网膜切除术的患者。胃周区域有肉眼可见侵犯、非上皮性浆液性肿瘤以及卵巢癌复发的患者被排除。分离胃周区域并进行全面病理检查。
纳入24例患者。6例患者接受了初次肿瘤细胞减灭术，18例患者接受了中间性肿瘤细胞减灭术。胃周区域病理切片的平均数量为24张（范围为8至41张）。62.5%的病例发现胃周网膜区域有显微镜下侵犯。1例患者为低级别浆液性癌，胃周区域有显微镜下侵犯。在23例高级别浆液性癌患者中，12例网膜其他部位有肉眼可见侵犯的患者中有10例（83%）胃周区域有显微镜下侵犯。11例网膜肉眼外观正常的患者中有4例（36.3%）胃周弓状缘有显微镜下病变。
本研究表明，无论网膜的肉眼外观如何，包括胃周区域的全网膜切除术是晚期卵巢癌完整肿瘤细胞减灭术的必要组成部分。
