Terauchi F, Tanabe K, Tenmyo M, Terauchi H, Ogura H
Second Department of Obstetrics and Gynecology, Toho University, School of Medicine, Tokyo.
Nihon Sanka Fujinka Gakkai Zasshi. 1995 Jan;47(1):14-8.
Omentumectomy as a basic surgical method at the site of metastasis of ovarian cancer was examined, and the importance of total omentumectomy was evaluated. Nineteen patients who underwent initial laparotomy and did not receive preoperative chemotherapy were examined histopathologically. 1. Omental metastasis was found in 9 of 19 patients (47%). 2. No significant correlation was seen between the maximum tumor diameter and omental metastasis. 3. No significant correlation was seen between the amount of ascites and omental metastasis. 4. Cytodiagnosis of the ascites and intraperitoneal lavage fluid showed significantly more omental metastasis in patients who tested positive. 5. Omentum in the upward direction from the teniae of the transverese colon showed a high incidence of metastasis. 6. Postoperative disturbances associated with total omentumectomy were mild. These results indicated that the omentum is the principle site of metastasis of ovarian cancer, and omentumectomy should be performed as total resection whenever possible since metastasis occurs in the upward direction because partial resection is not significant and postoperative disturbance is mild but there is the need for requiring further examination in the case of Ia stage.