Radical omentectomy for ovarian cancer
The role of omentectomy in ovarian cancer treatment
The role of omentectomy as part of debulking surgery for ovarian cancer. Historically, 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. The realization that ovarian cancer cells have a predisposition to metastasize to the omentum has led to the inclusion of omentectomy, both for accurate staging and therapeutic benefit of ovarian cancer. In apparently early stage epithelial ovarian cancer, microscopic disease in the omentum is found in 0-22% of the cases. In advanced disease omental metastasis is found in 35- 70%s; however extra-ovarian disease isolated to the omentum is found in 2-7% of cases at most. According to the NCCN and ESGO guidelines, radical omentectomy should be performed according to the Stage of the disease. Incomplete omentectomy led to relapse of the disease and reduction of the overall survival of the patient.
#oncology #ovarian cancer
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