China
Africa
Explore chapters and articles related to this topic
Laparoscopy
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
Farr Nezhat, Carmel Cohen, Nimesh P. Nagarsheth
Omentum frequently is involved with metastatic lesions whenever there is intra-abdominal spread of cancer. Omentectomy is part of the staging of ovarian cancer and is often performed in treating or staging other gynecologic cancers, such as uterine papillary serous adenocarcinoma.
Treatment considerations for high-grade appendiceal adenocarcinoma
Published in Wim P. Ceelen, Edward A. Levine, Intraperitoneal Cancer Therapy, 2015
Sean P. Dineen, Melissa Taggart, Richard E. Royal, Paul Mansfield, Keith F. Fournier
Patients that meet inclusion criteria after this thorough evaluation and treatment are scheduled for CRS/HIPEC after medical clearance. The technique for CRS/HIPEC is addressed in more detail in a separate chapter. Briefly, our operation begins with a midline incision from xiphoid to pubis. If a previous laparoscopy was performed, we excise the scar tissue from prior surgery. We use a self-retaining retractor that provides traction under both costal margins and in both paracolic gutters. A complete omentectomy is performed. If disease involves the spleen, or if needed to completely remove the omentum, a splenectomy is performed. Following this, we proceed in a systematic fashion from the right upper quadrant in a clockwise fashion. Peritoneal surfaces are stripped, and visceral resection is performed as needed to remove all visible disease. Once all visible disease is removed, the perfusion is begun. A temporary closure of skin only is completed with inflow and out-flow cannulas placed. HIPEC is performed using mitomycin C dosed at 20–25 mg/m2 (we use 20 mg/m2 for patients with prior systemic chemotherapy, which comprises the majority of patients with high-grade disease). Outflow temperatures are targeted to 41°C, and the patient is continuously agitated during the perfusion. We typically perfuse for 90 minutes. Once completed, GI continuity is restored for those patients who underwent a bowel resection.
Characteristics and clinicopathological features of patients with ovarian metastasis of endometrial cancer: a retrospective study
Published in Journal of Obstetrics and Gynaecology, 2022
Yusuke Matoba, Wataru Yamagami, Tatsuyuki Chiyoda, Yusuke Kobayashi, Eiichiro Tominaga, Kouji Banno, Daisuke Aoki
A total of 668 patients who met the inclusion criteria and did not meet the exclusion criteria were included in the study (Figure 1). The median age was 55 (range 24–87) years. Regarding the surgical procedures, 197 cases (29.5%) underwent hysterectomy and BSO only, 253 (37.9%) underwent pelvic lymphadenectomy, and 218 (32.6%) underwent pelvic lymphadenectomy and para-aortic lymphadenectomy. Omentectomy was performed in 229 cases (34.3%). Ascitic fluid samples for cytology were not collected in 7 patients (1%). The stages were Stage IA, 415 (62.1%); IB, 101 (15.1%); II, 37 (5.5%); III, unknown subclass, 1 (0.1%); IIIA, 25 (3.7%); IIIB, 3 (0.4%); IIIC1, 25 (3.7%); IIIC2, 40 (6.0%); IVA, 1 (0.1%); and IVB, 20 (3.0%). There were 595 patients with endometrioid carcinoma (89.1%), 33 (4.9%) with serous carcinoma, and 14 (2.1%) with clear cell carcinoma. The breakdown of histological types was endometrioid carcinoma (EM) grade 1 (G1), 332 (49.7%); grade 2 (G2), 180 (26.9%); and G3, 83 (12.4%) (Supplemental table 2).
Lymphadenectomy in Primary Fallopian Tube Cancer is Associated with Improved Survival
Published in Journal of Investigative Surgery, 2022
Yao Xiao, Yue-xi Liu, Ruo-nan Li, Xing Wei, Qing-miao Wang, Qiu-ying Gu, Hua Linghu
The latest guidelines for OC recommend para-aortic and pelvic lymphadenectomy for all early-stage invasive EOC. For advanced-stage patients, it should only be performed on suspicious and/or enlarged nodes and not on clinically negative nodes. However, we still suggest lymphadenectomy in all patients with PFTC if it is tolerable. Omentectomy is suggested in all newly diagnosed patients. Our results showed that most of the omentum involvement in PFTC was isolated nodules, and omentum metastasis had no significant effect on the prognosis of patients with the same FIGO stage. This led us to hypothesize that if it is necessary to reassess the value of omentectomy in PFTC. However, it is insufficient to assess the involvement of the greater omentum properly only through imaging and surgical exploration and it remains controversial to balance the pros and cons of omentectomy. This is a significant area of investigation that necessitates better evidence.
Diagnosis and management of uterine serous carcinoma: current strategies and clinical challenges
Published in Expert Opinion on Orphan Drugs, 2020
Omar Najjar, Britt K. Erickson, Amanda N. Nickles-Fader
Omentectomy is also recommended as a component of comprehensive surgical staging in all women with USC. In a retrospective review of 66 women with USC who underwent omental biopsy, eight (12%) had omental metastases, including 6 lesions that were visible intraoperatively or on preoperative CT and 2 (3%) micro-metastases [30]. Similarly, a study of 98 Turkish women with USC who underwent omentectomy found that 17 (17%) had omental metastases, 8 (8%) of which were occult [31]. Omental involvement leads to the diagnosis of stage IV disease and may impact management strategies in women with apparent early-stage disease. Comprehensive surgical staging may also enhance survival outcomes in women with USC. A review of 41 cases of apparent stage I USC reported that comprehensive staging was completed in 29% of patients, including pelvic and para-aortic lymphadenectomy, total omentectomy, and peritoneal biopsies [32]. Staging was associated with improved disease-specific survival (p = 0.037).