The role of omentectomy and appendectomy during the surgical staging of clinical stage I endometrial cancer

Assesment of extrauterine spread is the most important objective of surgical staging in the endometrioid adenocarcinoma of uterine corpus. The role of omentectomy and appendectomy in the staging procedure is unclear. In this study, our objective was to determine whether omentectomy and appendectomy should be a part of the surgical staging in endometrioid adenocarcinoma of uterine corpus. Fifty-one patients who were diagnosed as clinical stage I endometrioid adenocarcinoma of corpus uteri were reviewed. Demographic, clinicopathologic, and survillence data were collected from hospital charts. Grade, myometrial invasion, cervical and adnexal involvement and positive peritoneal cytology, lymph node and omentum and appendix involvement were recorded. The median age of 51 women was 60.45 years. Median follow-up period was 46.19 months. Microscopic omental involvement was detected in three cases (6%). Two cases (3.9%) of metastasis to appendix were seen. Omentum metastasis was more common in the patient with adnexal involvement, lymph node metastasis, and deep myometrial invasion (P= 0. 014, P= 0. 046, and P= 0. 033, respectively). Median survival was 53 months. We conclude that omentectomy gives additional information about extrauterine spread of tumor without increased operational morbidity and should be performed as a component of surgical staging in the presence of normal appeared omentum.