Microscopic Omental Metastasis in Clinical Stage I Endometrial Cancer: A Meta-analysis
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A patient with early-stage endometrial cancer may possibly have microscopic metastasis in the omentum, which is associated with a poor prognosis. The purpose of this study was to identify risk factors for microscopic omental metastasis in patients with clinical stage I endometrial cancer to establish the indications for selective omentectomy.
We searched the PubMed, EMBASE, and Cochrane Library databases for published studies from inception to August 2014, using terms such as ‘endometrial cancer’ or ‘uterine cancer’ for disease, ‘omentectomy’ or ‘omental biopsy’ for intervention, and ‘metastasis’ for outcome. Two reviewers independently identified the studies that matched the selection criteria. We calculated the pooled risk ratios (RRs) with 95 % confidence intervals (CI) of each surgicopathologic finding for microscopic omental metastases in clinical stage I endometrial cancer. We also calculated the prevalence of microscopic omental metastases.
Among 1163 patients from ten studies, 22 cases (1.9 %) of microscopic omental metastases were found, which accounted for 26.5 % of all omental metastases. Positive lymph nodes (RR 8.71, 95 % CI 1.38–54.95), adnexal metastases (RR 16.76, 95 % CI 2.60–107.97), and appendiceal implants (RR 161.67, 95 % CI 5.16–5061.03) were highly associated with microscopic omental metastases.
Microscopic omental metastases were not negligible in patients with clinical stage I endometrial cancer. Those with a risk factor of microscopic omental metastases were recommended for selective omentectomy.
KeywordsEndometrial Cancer Clinical Stage Endometrioid Adenocarcinoma Positive Cytology Cochrane Library Database
This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A070001). The study was presented as a poster abstract at the Society of Gynecologic Oncology 44th Annual Meeting on Women’s Cancer, Los Angeles, CA, USA, on 10 March 2013.
Won Duk Joo, Peter E. Schwartz, Thomas J. Rutherford, Seok Ju Seong, Junbeom Ku, Hyun Park, Sang Geun Jung, Min Chul Choi, and Chan Lee report no conflicts of interest.
- 5.National Comprehensive Cancer Network. Uterine neoplasms. NCCN clinical practice guidelines in oncology. Fort Washington (PA): National Comprehensive Cancer Network, Inc., 2012.Google Scholar
- 7.Ruvalcaba-Limon E, Cantu-de-Leon D, Leon-Rodriguez E, et al. The first Mexican consensus of endometrial cancer. Grupo de Investigacion en Cancer de Ovario y Tumores Ginecologicos de Mexico [in Spanish]. Rev Invest Clin. 2010;62:583, 85–605.Google Scholar
- 8.Korean Society of Gynecologic Oncology. Practice guideline for gynecologic cancer. In: Park SY (ed). Korean Society of Gynecologic Oncology; 2010.Google Scholar
- 9.Dowdy SC, Mariani A, Lurain JR. Uterine cancer. In: Berek JS (ed). Berek and Novak’s Gynecology. Philadelpia (PA): Lippincott Williams & Wilkins; 2012.Google Scholar
- 25.Gynecologic Oncology Group. Pelvic radiation therapy or vaginal implant radiation therapy, paclitaxel, and carboplatin in treating patients with high-risk stage I or stage II endometrial cancer. Bethesda: National Cancer Institute; 2012.Google Scholar