The role of omentectomy in the surgical treatment of uterine serous carcinoma

Abstract

The role of omentectomy in the surgical treatment of uterine serous carcinoma Ming Chena, Peng Guoa, Jifan Tanb, Duo Liua, Shuzhong Yaoa,* a Department of Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China b Reproductive Medicine Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China A R T I C L E I N F O Article history: Received 7 March 2019 Received in revised form 23 June 2019 Accepted 8 July 2019 Available online 10 July 2019 Keywords: Uterine serous cancer Omentectomy Surgical staging Survival A B S T R A C T Objective: The aims of this study were to assess the role of omentectomy in the staging of uterine serous carcinoma (USC) and to evaluate its impact on patient outcomes. Study design: Patients diagnosed with USC at the First Affiliated Hospital of Sun Yat-sen University of China were retrospectively reviewed. The clinicopathological characteristics and survival data of 187 patients were analyzed. Risk factors for omental metastasis were evaluated. Kaplan–Meier survival curves were used to compare survival status and the presence of omental metastasis. Results: We found that 35 of 187 patients (18.7%) had omental metastases. Omental metastasis was significantly associated with adnexal involvement (40.0% vs 19.1%, P = 0.008, OR 2.828, 95% CI 1.286– 6.218). Multivariate analysis showed that in addition to lymph node metastases and suboptimal surgery, omental metastasis in USC remained an independent predictor of decreased PFS and OS (PFS, HR 1.48, 95% CI 1.14–4.63, P = 0.024; OS, HR 1.39, 95% CI 1.04–3.60, P = 0.043). Conclusions: The incidence of omental metastasis is not low in patients with USC. Visual assessment and omental biopsy may be insufficient for recognizing occult metastases. Omentectomy should be part of the staging surgery in USC patients because it provides additional information about survival. Prospective studies are needed to confirm these results.