Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Erciyes University, Kayseri, Turkey.
Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey.
Curr Probl Cancer. 2023 Dec;47(6):101018. doi: 10.1016/j.currproblcancer.2023.101018. Epub 2023 Oct 13.
To investigate the risk factors for occult omental metastasis and the effect of omentectomy on the survival of type 2 endometrial cancer (EC) patients. This study enrolled patients who were diagnosed with high-risk (grade 3, serous, clear cell, undifferentiated, carcinosarcoma, or mixed type) EC between 2000 and 2021 and underwent surgery in our center. Data from 482 patients were analyzed retrospectively. Omentectomy was performed in 405 (84.0%) patients. Omental metastases were detected in 61 (12.7%) patients. Eighteen (29.5%) of these metastases were occult. Adnexal involvement, malignant cytology, and peritoneal spread were independent risk factors for omental metastasis. The 5-year overall survival (OS) rate was 59.5% in patients who underwent omentectomy and 64.7% in those who did not (P = 0.558). In patients with and without omental metastases, the overall 5-year OS rates were 34.9% and 63.5%, respectively (P < 0.001). The 5-year OS rates of patients with a normal omentum, gross tumors, and occult metastases were 63.5%, 26.9%, and 52.5%, respectively (P < 0.001). Omental metastases is not uncommon in type II endometrial cancer; approximately one third of patients have occult metastases. Factors - positive cytology, adnexal involvement, and peritoneal involvement are associated with higher probability of omental metastases.
探讨隐匿性大网膜转移的危险因素以及大网膜切除术对 II 型子宫内膜癌（EC）患者生存的影响。本研究纳入了 2000 年至 2021 年期间在我院诊断为高危（分级 3 级、浆液性、透明细胞性、未分化、癌肉瘤或混合性）EC 并接受手术治疗的患者。回顾性分析了 482 例患者的数据。405 例（84.0%）患者接受了大网膜切除术。61 例（12.7%）患者检测到大网膜转移。其中 18 例（29.5%）为隐匿性转移。附件受累、恶性细胞学和腹膜播散是大网膜转移的独立危险因素。行大网膜切除术的患者 5 年总生存率（OS）为 59.5%，未行大网膜切除术的患者为 64.7%（P=0.558）。有和无大网膜转移的患者的总 5 年 OS 率分别为 34.9%和 63.5%（P<0.001）。大网膜正常、肉眼可见肿瘤和隐匿性转移患者的 5 年 OS 率分别为 63.5%、26.9%和 52.5%（P<0.001）。 II 型子宫内膜癌中隐匿性大网膜转移并不少见；约三分之一的患者有隐匿性转移。阳性细胞学、附件受累和腹膜受累是大网膜转移的高概率相关因素。
