The Experts below are selected from a list of 6156 Experts worldwide ranked by ideXlab platform
Lior Lowenstein - One of the best experts on this subject based on the ideXlab platform.
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transvaginal natural orifice transluminal endoscopic surgery vnotes for Omentectomy a case series
Surgical Oncology-oxford, 2020Co-Authors: Lior Lowenstein, Emad Matanes, Roy Lauterbach, Sari Boulus, Amnon Amit, Jan BaekelandtAbstract:Abstract Background and objective Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has been applied massively in the gynecological field in recent years. The aim of the current study is to present the surgical technique of vNOTES Omentectomy and to evaluate the feasibility of this procedure. Methods A case series study of the first 5 vNOTES Omentectomy procedures performed for surgical staging of suspicious early stage ovarian cancer, at Rambam Health Care Campus (Israel) and Imelda Hospital (Belgium) between November 2018 and August 2019. Sociodemographic and clinical data were retrieved from patients’ electronic charts. Primary points of interest included intra-operative bleeding, length of surgery, length of hospitalization, and surgical complications. Results The median age was 61 years (range 50–72), and the median BMI was 27 kg/m2 (range 23–33). All the operations were carried out to completion through the vaginal GelPOINT, without insertion of an assistant abdominal trocar or conversion to another surgical approach. The median Omentectomy time was 45 min (range: 39–52). The median estimated intraoperative blood loss was 150 ml (range: 20–200). The median hospital stay was 2 days (range: 1–3). Conclusions vNOTES is a feasible technique for Omentectomy in early stage ovarian cancer, with low rates of complications and improved cosmetic results.
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Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for Omentectomy - A case series.
Surgical oncology, 2020Co-Authors: Lior Lowenstein, Emad Matanes, Roy Lauterbach, Sari Boulus, Amnon Amit, Jan BaekelandtAbstract:Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has been applied massively in the gynecological field in recent years. The aim of the current study is to present the surgical technique of vNOTES Omentectomy and to evaluate the feasibility of this procedure. A case series study of the first 5 vNOTES Omentectomy procedures performed for surgical staging of suspicious early stage ovarian cancer, at Rambam Health Care Campus (Israel) and Imelda Hospital (Belgium) between November 2018 and August 2019. Sociodemographic and clinical data were retrieved from patients' electronic charts. Primary points of interest included intra-operative bleeding, length of surgery, length of hospitalization, and surgical complications. The median age was 61 years (range 50-72), and the median BMI was 27 kg/m2 (range 23-33). All the operations were carried out to completion through the vaginal GelPOINT, without insertion of an assistant abdominal trocar or conversion to another surgical approach. The median Omentectomy time was 45 min (range: 39-52). The median estimated intraoperative blood loss was 150 ml (range: 20-200). The median hospital stay was 2 days (range: 1-3). vNOTES is a feasible technique for Omentectomy in early stage ovarian cancer, with low rates of complications and improved cosmetic results. Copyright © 2020 Elsevier Ltd. All rights reserved.
Jan Baekelandt - One of the best experts on this subject based on the ideXlab platform.
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transvaginal natural orifice transluminal endoscopic surgery vnotes for Omentectomy a case series
Surgical Oncology-oxford, 2020Co-Authors: Lior Lowenstein, Emad Matanes, Roy Lauterbach, Sari Boulus, Amnon Amit, Jan BaekelandtAbstract:Abstract Background and objective Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has been applied massively in the gynecological field in recent years. The aim of the current study is to present the surgical technique of vNOTES Omentectomy and to evaluate the feasibility of this procedure. Methods A case series study of the first 5 vNOTES Omentectomy procedures performed for surgical staging of suspicious early stage ovarian cancer, at Rambam Health Care Campus (Israel) and Imelda Hospital (Belgium) between November 2018 and August 2019. Sociodemographic and clinical data were retrieved from patients’ electronic charts. Primary points of interest included intra-operative bleeding, length of surgery, length of hospitalization, and surgical complications. Results The median age was 61 years (range 50–72), and the median BMI was 27 kg/m2 (range 23–33). All the operations were carried out to completion through the vaginal GelPOINT, without insertion of an assistant abdominal trocar or conversion to another surgical approach. The median Omentectomy time was 45 min (range: 39–52). The median estimated intraoperative blood loss was 150 ml (range: 20–200). The median hospital stay was 2 days (range: 1–3). Conclusions vNOTES is a feasible technique for Omentectomy in early stage ovarian cancer, with low rates of complications and improved cosmetic results.
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Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for Omentectomy - A case series.
Surgical oncology, 2020Co-Authors: Lior Lowenstein, Emad Matanes, Roy Lauterbach, Sari Boulus, Amnon Amit, Jan BaekelandtAbstract:Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has been applied massively in the gynecological field in recent years. The aim of the current study is to present the surgical technique of vNOTES Omentectomy and to evaluate the feasibility of this procedure. A case series study of the first 5 vNOTES Omentectomy procedures performed for surgical staging of suspicious early stage ovarian cancer, at Rambam Health Care Campus (Israel) and Imelda Hospital (Belgium) between November 2018 and August 2019. Sociodemographic and clinical data were retrieved from patients' electronic charts. Primary points of interest included intra-operative bleeding, length of surgery, length of hospitalization, and surgical complications. The median age was 61 years (range 50-72), and the median BMI was 27 kg/m2 (range 23-33). All the operations were carried out to completion through the vaginal GelPOINT, without insertion of an assistant abdominal trocar or conversion to another surgical approach. The median Omentectomy time was 45 min (range: 39-52). The median estimated intraoperative blood loss was 150 ml (range: 20-200). The median hospital stay was 2 days (range: 1-3). vNOTES is a feasible technique for Omentectomy in early stage ovarian cancer, with low rates of complications and improved cosmetic results. Copyright © 2020 Elsevier Ltd. All rights reserved.
Nelson N.h. Teng - One of the best experts on this subject based on the ideXlab platform.
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Does Omentectomy in epithelial ovarian cancer affect survival? An analysis of the Surveillance, Epidemiology, and End Results database.
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2015Co-Authors: Leah Mcnally, Nelson N.h. Teng, Daniel S. Kapp, Amer KaramAbstract:OBJECTIVE Although Omentectomy is part of the staging and treatment of epithelial ovarian cancer (EOC), its performance in a patient with a grossly normal omentum—acknowledging its role in debulking gross tumor deposits—has never been definitively shown to improve survival. METHODS/MATERIALS Using Surveillance, Epidemiology, and End Results data from 1998 to 2010, we identified patients with EOC and assessed their age, race, year of diagnosis, tumor grade, histologic subtype, International Federation of Gynecology and Obstetrics stage, lymph node dissection, nodal findings, and performance of Omentectomy. We compared disease-specific survival (DSS) based on the presence or absence of Omentectomy using log-rank univariate analysis, Cox multivariate analysis, and Kaplan-Meier survival curves. RESULTS A total of 20,975 patients with invasive EOC underwent surgical treatment. Initial univariate analysis indicated a lower mean DSS with performance of Omentectomy. However, multivariate analysis demonstrated no significant association between DSS and performance of Omentectomy (hazard ratio, 0.978; P = 0.506). The DSS was improved if lymphadenectomy was performed (hazard ratio, 0.60; P < 0.001). In recent years, there was a trend toward decreased performance of Omentectomy.To look specifically at patients without bulky omental disease, a subset analysis was done looking at patients with stage I-IIIA disease who had had lymphadenectomy performed. There were 5454 patients in the group who underwent an Omentectomy and 2404 patients in the group who did not. No difference in DSS was seen between the groups based on performance of Omentectomy (P = 0.89). However, the analysis was limited by the lack of Surveillance, Epidemiology, and End Results data on the extent of Omentectomy, amount of residual disease, and adjuvant chemotherapy. CONCLUSIONS In this analysis, performance of Omentectomy in patients with EOC without bulky disease (≤stage IIIA) did not seem to confer improvement in survival. A randomized control trial would be needed to fully address this question.
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does Omentectomy in epithelial ovarian cancer affect survival an analysis of the surveillance epidemiology and end results database
International Journal of Gynecological Cancer, 2015Co-Authors: Leah Mcnally, Nelson N.h. Teng, Daniel S. Kapp, Amer KaramAbstract:Objective Although Omentectomy is part of the staging and treatment of epithelial ovarian cancer (EOC), its performance in a patient with a grossly normal omentum—acknowledging its role in debulking gross tumor deposits—has never been definitively shown to improve survival. Methods/Materials Using Surveillance, Epidemiology, and End Results data from 1998 to 2010, we identified patients with EOC and assessed their age, race, year of diagnosis, tumor grade, histologic subtype, International Federation of Gynecology and Obstetrics stage, lymph node dissection, nodal findings, and performance of Omentectomy. We compared disease-specific survival (DSS) based on the presence or absence of Omentectomy using log-rank univariate analysis, Cox multivariate analysis, and Kaplan-Meier survival curves. Results A total of 20,975 patients with invasive EOC underwent surgical treatment. Initial univariate analysis indicated a lower mean DSS with performance of Omentectomy. However, multivariate analysis demonstrated no significant association between DSS and performance of Omentectomy (hazard ratio, 0.978; P = 0.506). The DSS was improved if lymphadenectomy was performed (hazard ratio, 0.60; P To look specifically at patients without bulky omental disease, a subset analysis was done looking at patients with stage I-IIIA disease who had had lymphadenectomy performed. There were 5454 patients in the group who underwent an Omentectomy and 2404 patients in the group who did not. No difference in DSS was seen between the groups based on performance of Omentectomy (P = 0.89). However, the analysis was limited by the lack of Surveillance, Epidemiology, and End Results data on the extent of Omentectomy, amount of residual disease, and adjuvant chemotherapy. Conclusions In this analysis, performance of Omentectomy in patients with EOC without bulky disease (≤stage IIIA) did not seem to confer improvement in survival. A randomized control trial would be needed to fully address this question.
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the omentum and Omentectomy in epithelial ovarian cancer a reappraisal part ii the role of Omentectomy in the staging and treatment of apparent early stage epithelial ovarian cancer
Gynecologic Oncology, 2013Co-Authors: Leah Mcnally, Daniel S. Kapp, Alon Ben Arie, Nelson N.h. TengAbstract:Abstract Objective This article reviews the literature concerning the role of Omentectomy in the staging and treatment of clinically apparent early stage epithelial ovarian cancer. Methods A review of the English language literature based on a MEDLINE (PubMed) database search using the keywords: ovary, cancer, carcinoma, omentum, and Omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers. Results Historically, the realization that ovarian cancer cells have a predisposition to metastasize to the omentum has led to the inclusion of Omentectomy, both for the purpose of accurate staging of ovarian cancer and for its possible therapeutic benefit. In apparently early stage epithelial ovarian cancer, microscopic disease in the omentum is found in 0–22% of the cases; however extra-ovarian disease isolated to the omentum is found in 2–7% of cases at most. There are no specific guidelines as to how much of the omentum should be removed, but pathology studies show that for the purpose of staging and detecting microscopic disease, omental biopsies are probably sufficient in a grossly normal appearing omentum. In cases where adjuvant chemotherapy is planned, the role of Omentectomy appears to be primarily for staging, while its therapeutic role remains unclear in microscopic omental disease. Conclusions In apparent early stage ovarian cancer, the presence of isolated omental metastases is relatively rare. For staging purposes in such cases, random omental biopsies rather than total Omentectomy may suffice. Furthermore, chemotherapy appears to effectively treat microscopic disease and therefore if this is already planned the benefit of Omentectomy is unclear.
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The omentum and Omentectomy in epithelial ovarian cancer: A reappraisal: Part II — The role of Omentectomy in the staging and treatment of apparent early stage epithelial ovarian cancer
Gynecologic oncology, 2013Co-Authors: Alon Ben Arie, Leah Mcnally, Daniel S. Kapp, Nelson N.h. TengAbstract:Abstract Objective This article reviews the literature concerning the role of Omentectomy in the staging and treatment of clinically apparent early stage epithelial ovarian cancer. Methods A review of the English language literature based on a MEDLINE (PubMed) database search using the keywords: ovary, cancer, carcinoma, omentum, and Omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers. Results Historically, the realization that ovarian cancer cells have a predisposition to metastasize to the omentum has led to the inclusion of Omentectomy, both for the purpose of accurate staging of ovarian cancer and for its possible therapeutic benefit. In apparently early stage epithelial ovarian cancer, microscopic disease in the omentum is found in 0–22% of the cases; however extra-ovarian disease isolated to the omentum is found in 2–7% of cases at most. There are no specific guidelines as to how much of the omentum should be removed, but pathology studies show that for the purpose of staging and detecting microscopic disease, omental biopsies are probably sufficient in a grossly normal appearing omentum. In cases where adjuvant chemotherapy is planned, the role of Omentectomy appears to be primarily for staging, while its therapeutic role remains unclear in microscopic omental disease. Conclusions In apparent early stage ovarian cancer, the presence of isolated omental metastases is relatively rare. For staging purposes in such cases, random omental biopsies rather than total Omentectomy may suffice. Furthermore, chemotherapy appears to effectively treat microscopic disease and therefore if this is already planned the benefit of Omentectomy is unclear.
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The Omentum and Omentectomy in epithelial ovarian cancer: A reappraisal Part I - Omental function and history of Omentectomy
Gynecologic oncology, 2013Co-Authors: Alon Ben Arie, Leah Mcnally, Daniel S. Kapp, Nelson N.h. TengAbstract:Abstract Objective This article reviews the literature concerning the function of the omentum and how Omentectomy came to be part of the staging and treatment of epithelial ovarian cancer. Methods A review of the English language literature based on a MEDLINE (PubMed) database search using the key words: ovary, cancer, carcinoma, omentum, and Omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers. Results Descriptions of the omentum can be found as far back as the time of the ancient Egyptians. An immunologic role of the omentum was confirmed in 1980s when "milky spots" were described. Omentectomy arrived as part of the ovarian cancer guidelines in the 1960s after observing that the omentum was a frequent site of metastasis and that patients with removal of all diseased tissue did better. The exact role of the omentum in immunology and cancer remains incompletely understood. Conclusions Historically, occult omental metastases in otherwise early disease have led to the inclusion of Omentectomy for the purpose of accurate staging and for a possible therapeutic benefit. Laboratory studies on the role in cancer of the omental fat and milky spots are controversial.
Alon Ben Arie - One of the best experts on this subject based on the ideXlab platform.
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the omentum and Omentectomy in epithelial ovarian cancer a reappraisal part ii the role of Omentectomy in the staging and treatment of apparent early stage epithelial ovarian cancer
Gynecologic Oncology, 2013Co-Authors: Leah Mcnally, Daniel S. Kapp, Alon Ben Arie, Nelson N.h. TengAbstract:Abstract Objective This article reviews the literature concerning the role of Omentectomy in the staging and treatment of clinically apparent early stage epithelial ovarian cancer. Methods A review of the English language literature based on a MEDLINE (PubMed) database search using the keywords: ovary, cancer, carcinoma, omentum, and Omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers. Results Historically, the realization that ovarian cancer cells have a predisposition to metastasize to the omentum has led to the inclusion of Omentectomy, both for the purpose of accurate staging of ovarian cancer and for its possible therapeutic benefit. In apparently early stage epithelial ovarian cancer, microscopic disease in the omentum is found in 0–22% of the cases; however extra-ovarian disease isolated to the omentum is found in 2–7% of cases at most. There are no specific guidelines as to how much of the omentum should be removed, but pathology studies show that for the purpose of staging and detecting microscopic disease, omental biopsies are probably sufficient in a grossly normal appearing omentum. In cases where adjuvant chemotherapy is planned, the role of Omentectomy appears to be primarily for staging, while its therapeutic role remains unclear in microscopic omental disease. Conclusions In apparent early stage ovarian cancer, the presence of isolated omental metastases is relatively rare. For staging purposes in such cases, random omental biopsies rather than total Omentectomy may suffice. Furthermore, chemotherapy appears to effectively treat microscopic disease and therefore if this is already planned the benefit of Omentectomy is unclear.
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The omentum and Omentectomy in epithelial ovarian cancer: A reappraisal: Part II — The role of Omentectomy in the staging and treatment of apparent early stage epithelial ovarian cancer
Gynecologic oncology, 2013Co-Authors: Alon Ben Arie, Leah Mcnally, Daniel S. Kapp, Nelson N.h. TengAbstract:Abstract Objective This article reviews the literature concerning the role of Omentectomy in the staging and treatment of clinically apparent early stage epithelial ovarian cancer. Methods A review of the English language literature based on a MEDLINE (PubMed) database search using the keywords: ovary, cancer, carcinoma, omentum, and Omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers. Results Historically, the realization that ovarian cancer cells have a predisposition to metastasize to the omentum has led to the inclusion of Omentectomy, both for the purpose of accurate staging of ovarian cancer and for its possible therapeutic benefit. In apparently early stage epithelial ovarian cancer, microscopic disease in the omentum is found in 0–22% of the cases; however extra-ovarian disease isolated to the omentum is found in 2–7% of cases at most. There are no specific guidelines as to how much of the omentum should be removed, but pathology studies show that for the purpose of staging and detecting microscopic disease, omental biopsies are probably sufficient in a grossly normal appearing omentum. In cases where adjuvant chemotherapy is planned, the role of Omentectomy appears to be primarily for staging, while its therapeutic role remains unclear in microscopic omental disease. Conclusions In apparent early stage ovarian cancer, the presence of isolated omental metastases is relatively rare. For staging purposes in such cases, random omental biopsies rather than total Omentectomy may suffice. Furthermore, chemotherapy appears to effectively treat microscopic disease and therefore if this is already planned the benefit of Omentectomy is unclear.
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The Omentum and Omentectomy in epithelial ovarian cancer: A reappraisal Part I - Omental function and history of Omentectomy
Gynecologic oncology, 2013Co-Authors: Alon Ben Arie, Leah Mcnally, Daniel S. Kapp, Nelson N.h. TengAbstract:Abstract Objective This article reviews the literature concerning the function of the omentum and how Omentectomy came to be part of the staging and treatment of epithelial ovarian cancer. Methods A review of the English language literature based on a MEDLINE (PubMed) database search using the key words: ovary, cancer, carcinoma, omentum, and Omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers. Results Descriptions of the omentum can be found as far back as the time of the ancient Egyptians. An immunologic role of the omentum was confirmed in 1980s when "milky spots" were described. Omentectomy arrived as part of the ovarian cancer guidelines in the 1960s after observing that the omentum was a frequent site of metastasis and that patients with removal of all diseased tissue did better. The exact role of the omentum in immunology and cancer remains incompletely understood. Conclusions Historically, occult omental metastases in otherwise early disease have led to the inclusion of Omentectomy for the purpose of accurate staging and for a possible therapeutic benefit. Laboratory studies on the role in cancer of the omental fat and milky spots are controversial.
Leah Mcnally - One of the best experts on this subject based on the ideXlab platform.
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Does Omentectomy in epithelial ovarian cancer affect survival? An analysis of the Surveillance, Epidemiology, and End Results database.
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2015Co-Authors: Leah Mcnally, Nelson N.h. Teng, Daniel S. Kapp, Amer KaramAbstract:OBJECTIVE Although Omentectomy is part of the staging and treatment of epithelial ovarian cancer (EOC), its performance in a patient with a grossly normal omentum—acknowledging its role in debulking gross tumor deposits—has never been definitively shown to improve survival. METHODS/MATERIALS Using Surveillance, Epidemiology, and End Results data from 1998 to 2010, we identified patients with EOC and assessed their age, race, year of diagnosis, tumor grade, histologic subtype, International Federation of Gynecology and Obstetrics stage, lymph node dissection, nodal findings, and performance of Omentectomy. We compared disease-specific survival (DSS) based on the presence or absence of Omentectomy using log-rank univariate analysis, Cox multivariate analysis, and Kaplan-Meier survival curves. RESULTS A total of 20,975 patients with invasive EOC underwent surgical treatment. Initial univariate analysis indicated a lower mean DSS with performance of Omentectomy. However, multivariate analysis demonstrated no significant association between DSS and performance of Omentectomy (hazard ratio, 0.978; P = 0.506). The DSS was improved if lymphadenectomy was performed (hazard ratio, 0.60; P < 0.001). In recent years, there was a trend toward decreased performance of Omentectomy.To look specifically at patients without bulky omental disease, a subset analysis was done looking at patients with stage I-IIIA disease who had had lymphadenectomy performed. There were 5454 patients in the group who underwent an Omentectomy and 2404 patients in the group who did not. No difference in DSS was seen between the groups based on performance of Omentectomy (P = 0.89). However, the analysis was limited by the lack of Surveillance, Epidemiology, and End Results data on the extent of Omentectomy, amount of residual disease, and adjuvant chemotherapy. CONCLUSIONS In this analysis, performance of Omentectomy in patients with EOC without bulky disease (≤stage IIIA) did not seem to confer improvement in survival. A randomized control trial would be needed to fully address this question.
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does Omentectomy in epithelial ovarian cancer affect survival an analysis of the surveillance epidemiology and end results database
International Journal of Gynecological Cancer, 2015Co-Authors: Leah Mcnally, Nelson N.h. Teng, Daniel S. Kapp, Amer KaramAbstract:Objective Although Omentectomy is part of the staging and treatment of epithelial ovarian cancer (EOC), its performance in a patient with a grossly normal omentum—acknowledging its role in debulking gross tumor deposits—has never been definitively shown to improve survival. Methods/Materials Using Surveillance, Epidemiology, and End Results data from 1998 to 2010, we identified patients with EOC and assessed their age, race, year of diagnosis, tumor grade, histologic subtype, International Federation of Gynecology and Obstetrics stage, lymph node dissection, nodal findings, and performance of Omentectomy. We compared disease-specific survival (DSS) based on the presence or absence of Omentectomy using log-rank univariate analysis, Cox multivariate analysis, and Kaplan-Meier survival curves. Results A total of 20,975 patients with invasive EOC underwent surgical treatment. Initial univariate analysis indicated a lower mean DSS with performance of Omentectomy. However, multivariate analysis demonstrated no significant association between DSS and performance of Omentectomy (hazard ratio, 0.978; P = 0.506). The DSS was improved if lymphadenectomy was performed (hazard ratio, 0.60; P To look specifically at patients without bulky omental disease, a subset analysis was done looking at patients with stage I-IIIA disease who had had lymphadenectomy performed. There were 5454 patients in the group who underwent an Omentectomy and 2404 patients in the group who did not. No difference in DSS was seen between the groups based on performance of Omentectomy (P = 0.89). However, the analysis was limited by the lack of Surveillance, Epidemiology, and End Results data on the extent of Omentectomy, amount of residual disease, and adjuvant chemotherapy. Conclusions In this analysis, performance of Omentectomy in patients with EOC without bulky disease (≤stage IIIA) did not seem to confer improvement in survival. A randomized control trial would be needed to fully address this question.
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the omentum and Omentectomy in epithelial ovarian cancer a reappraisal part ii the role of Omentectomy in the staging and treatment of apparent early stage epithelial ovarian cancer
Gynecologic Oncology, 2013Co-Authors: Leah Mcnally, Daniel S. Kapp, Alon Ben Arie, Nelson N.h. TengAbstract:Abstract Objective This article reviews the literature concerning the role of Omentectomy in the staging and treatment of clinically apparent early stage epithelial ovarian cancer. Methods A review of the English language literature based on a MEDLINE (PubMed) database search using the keywords: ovary, cancer, carcinoma, omentum, and Omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers. Results Historically, the realization that ovarian cancer cells have a predisposition to metastasize to the omentum has led to the inclusion of Omentectomy, both for the purpose of accurate staging of ovarian cancer and for its possible therapeutic benefit. In apparently early stage epithelial ovarian cancer, microscopic disease in the omentum is found in 0–22% of the cases; however extra-ovarian disease isolated to the omentum is found in 2–7% of cases at most. There are no specific guidelines as to how much of the omentum should be removed, but pathology studies show that for the purpose of staging and detecting microscopic disease, omental biopsies are probably sufficient in a grossly normal appearing omentum. In cases where adjuvant chemotherapy is planned, the role of Omentectomy appears to be primarily for staging, while its therapeutic role remains unclear in microscopic omental disease. Conclusions In apparent early stage ovarian cancer, the presence of isolated omental metastases is relatively rare. For staging purposes in such cases, random omental biopsies rather than total Omentectomy may suffice. Furthermore, chemotherapy appears to effectively treat microscopic disease and therefore if this is already planned the benefit of Omentectomy is unclear.
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The omentum and Omentectomy in epithelial ovarian cancer: A reappraisal: Part II — The role of Omentectomy in the staging and treatment of apparent early stage epithelial ovarian cancer
Gynecologic oncology, 2013Co-Authors: Alon Ben Arie, Leah Mcnally, Daniel S. Kapp, Nelson N.h. TengAbstract:Abstract Objective This article reviews the literature concerning the role of Omentectomy in the staging and treatment of clinically apparent early stage epithelial ovarian cancer. Methods A review of the English language literature based on a MEDLINE (PubMed) database search using the keywords: ovary, cancer, carcinoma, omentum, and Omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers. Results Historically, the realization that ovarian cancer cells have a predisposition to metastasize to the omentum has led to the inclusion of Omentectomy, both for the purpose of accurate staging of ovarian cancer and for its possible therapeutic benefit. In apparently early stage epithelial ovarian cancer, microscopic disease in the omentum is found in 0–22% of the cases; however extra-ovarian disease isolated to the omentum is found in 2–7% of cases at most. There are no specific guidelines as to how much of the omentum should be removed, but pathology studies show that for the purpose of staging and detecting microscopic disease, omental biopsies are probably sufficient in a grossly normal appearing omentum. In cases where adjuvant chemotherapy is planned, the role of Omentectomy appears to be primarily for staging, while its therapeutic role remains unclear in microscopic omental disease. Conclusions In apparent early stage ovarian cancer, the presence of isolated omental metastases is relatively rare. For staging purposes in such cases, random omental biopsies rather than total Omentectomy may suffice. Furthermore, chemotherapy appears to effectively treat microscopic disease and therefore if this is already planned the benefit of Omentectomy is unclear.
-
The Omentum and Omentectomy in epithelial ovarian cancer: A reappraisal Part I - Omental function and history of Omentectomy
Gynecologic oncology, 2013Co-Authors: Alon Ben Arie, Leah Mcnally, Daniel S. Kapp, Nelson N.h. TengAbstract:Abstract Objective This article reviews the literature concerning the function of the omentum and how Omentectomy came to be part of the staging and treatment of epithelial ovarian cancer. Methods A review of the English language literature based on a MEDLINE (PubMed) database search using the key words: ovary, cancer, carcinoma, omentum, and Omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers. Results Descriptions of the omentum can be found as far back as the time of the ancient Egyptians. An immunologic role of the omentum was confirmed in 1980s when "milky spots" were described. Omentectomy arrived as part of the ovarian cancer guidelines in the 1960s after observing that the omentum was a frequent site of metastasis and that patients with removal of all diseased tissue did better. The exact role of the omentum in immunology and cancer remains incompletely understood. Conclusions Historically, occult omental metastases in otherwise early disease have led to the inclusion of Omentectomy for the purpose of accurate staging and for a possible therapeutic benefit. Laboratory studies on the role in cancer of the omental fat and milky spots are controversial.
