Uterine papillary serous carcinoma pre-operatively diagnosed as endometrioid carcinoma: Is omentectomy necessary?

作者：Peled Yoav; Aviram Amir; Krissi Haim; Gershoni Assaf; Sabah Gad; Levavi Hanoch; Eitan Ram^*

来源：Australian & New Zealand Journal of Obstetrics & Gynaecology, 2015, 55(5): 498-502.

DOI：10.1111/ajo.12377

• endometrial carcinoma
• surgery
• survival

BackgroundUterine papillary serous carcinoma (UPSC) is a relatively rare but aggressive uterine malignancy comprising approximately 10% of endometrial cancers. Many women pre-operatively misdiagnosed as having endometrioid carcinoma have ultimately UPSC on final pathology. These women receive inadequate surgical staging without omentectomy.
AimTo assess the value of omentectomy on disease-free interval and overall survival in women with UPSC who had an initial diagnosis of endometrioid carcinoma.
MethodsThis retrospective study included all women treated for the final diagnosis of UPSC in our centre from January 2007 to December 2012. Data regarding patient demographics, staging procedures, histology results, adjuvant therapy and follow-up outcomes were recorded.
ResultsOf the 52 women with a final diagnosis of UPSC, more than 45% had an initial diagnosis of endometrioid carcinoma. All women underwent hysterectomy and removal of the adnexa. Lymph node evaluation was performed in 75% of women. Omentectomy was performed in 30/52 women (58%). Of those, three women (10%) had omental involvement. Mean disease-free interval with omentectomy was 24.5months versus 30.5months without (P=0.29). Mean overall survival was 33months with an omentectomy and 29months without (P=0.32). Recurrence patterns did not differ between groups.
ConclusionWomen diagnosed pre-operatively with endometrioid carcinoma and eventually found to have UPSC can expect no change in prognosis despite not having undertaken a full staging procedure. Repeat surgery for omentectomy is probably of no benefit.

• 出版日期2015-10