Abstract：
Non-endometrioid endometrial cancers (non-EEC) have different management from endometrioid endometrial cancers. The purpose of this study was to investigate the prognostic significance of omental disease and the role of omentectomy in non-endometrioid endometrial cancer and discuss the current literature with the findings.
The study included two hundred-three patients with non-EEC who underwent surgical treatment and follow-up between January 1996 and December 2018 in a University Hospital Gynecologic Oncology Center. The patients were divided into three groups according to whether omentectomy was performed and the presence of omental metastasis. The patient\'s demographics, clinical characteristics such as stage, grade, histopathologic type, lymphovascular space invasion (LVSI), myometrial invasion, lymph node involvement, and survival outcomes were compared between the groups.
The study included 203 patients. Twenty-five patients (12%) had omental metastases. LVSI was reported in 57.3%, 88.0%, and 43.2% of the non-omentectomy, no-omental metastasis, and omental metastatic groups, respectively (p = 0.001). The 5-year disease-free survival (DFS) and overall survival (OS) rates according to the tumor grade, peritoneal cytology, and lymphadenectomy were also compared and were found to be statistically similar. The five-year OS rates were 70.6% for the group without omental metastases and 16.2% for the group with omental metastases, respectively (p = 0.001). In the group of omentectomy, the five-year DFS rates were 62.2% in cases without omental metastasis and 13.0% in cases with omental metastasis (p = 0.001). The five-year OS rates of 86.3% and DFS rates of 80.0% in the group without omentectomy.
In non-endometrioid tumors, the survival rate was better in the group that did not undergo omentectomy. Based on these results, we can say that omentectomy may not be necessary for non-endometrioid tumors whose omentum is found to be normal in intraoperative visual examination.
The study included two hundred-three patients with non-EEC who underwent surgical treatment and follow-up between January 1996 and December 2018 in a University Hospital Gynecologic Oncology Center. The patients were divided into three groups according to whether omentectomy was performed and the presence of omental metastasis. The patient\'s demographics, clinical characteristics such as stage, grade, histopathologic type, lymphovascular space invasion (LVSI), myometrial invasion, lymph node involvement, and survival outcomes were compared between the groups.
The study included 203 patients. Twenty-five patients (12%) had omental metastases. LVSI was reported in 57.3%, 88.0%, and 43.2% of the non-omentectomy, no-omental metastasis, and omental metastatic groups, respectively (p = 0.001). The 5-year disease-free survival (DFS) and overall survival (OS) rates according to the tumor grade, peritoneal cytology, and lymphadenectomy were also compared and were found to be statistically similar. The five-year OS rates were 70.6% for the group without omental metastases and 16.2% for the group with omental metastases, respectively (p = 0.001). In the group of omentectomy, the five-year DFS rates were 62.2% in cases without omental metastasis and 13.0% in cases with omental metastasis (p = 0.001). The five-year OS rates of 86.3% and DFS rates of 80.0% in the group without omentectomy.
In non-endometrioid tumors, the survival rate was better in the group that did not undergo omentectomy. Based on these results, we can say that omentectomy may not be necessary for non-endometrioid tumors whose omentum is found to be normal in intraoperative visual examination.
摘要：
目的：非子宫内膜样子宫内膜癌（非EEC）与子宫内膜样子宫内膜癌的治疗方法不同。目的探讨非子宫内膜样子宫内膜癌大网膜疾病的预后意义和大网膜切除术的作用，并结合研究结果讨论目前的文献。
方法：该研究包括1996年1月至2018年12月在大学医院妇科肿瘤中心接受手术治疗和随访的200,3例非EEC患者。根据是否进行网膜切除术和是否存在网膜转移，将患者分为三组。病人的人口统计，临床特征，如分期，grade,组织病理学类型,淋巴管间隙侵犯（LVSI），子宫肌层浸润，淋巴结受累,并比较两组间的生存结局.
结果：该研究包括203名患者。25例患者（12％）有网膜转移。LVSI报告为57.3%，88.0%,43.2％的非网膜切除术，无网膜转移,和网膜转移组，分别(p=0.001)。5年无病生存率（DFS）和总生存率（OS）根据肿瘤分级，腹膜细胞学,和淋巴结清扫术也进行了比较，发现在统计学上相似。无网膜转移组5年OS率为70.6%,有网膜转移组5年OS率为16.2%,分别(p=0.001)。在网膜切除术组中，无网膜转移的5年DFS率为62.2%,有网膜转移的5年DFS率为13.0%(p=0.001)。未切除组5年OS率为86.3%,DFS率为80.0%。
结论：在非子宫内膜样肿瘤中，未进行网膜切除术组的生存率较好.基于这些结果,我们可以说，对于术中目视检查发现网膜正常的非子宫内膜样肿瘤，可能不需要进行网膜切除术。
方法：该研究包括1996年1月至2018年12月在大学医院妇科肿瘤中心接受手术治疗和随访的200,3例非EEC患者。根据是否进行网膜切除术和是否存在网膜转移，将患者分为三组。病人的人口统计，临床特征，如分期，grade,组织病理学类型,淋巴管间隙侵犯（LVSI），子宫肌层浸润，淋巴结受累,并比较两组间的生存结局.
结果：该研究包括203名患者。25例患者（12％）有网膜转移。LVSI报告为57.3%，88.0%,43.2％的非网膜切除术，无网膜转移,和网膜转移组，分别(p=0.001)。5年无病生存率（DFS）和总生存率（OS）根据肿瘤分级，腹膜细胞学,和淋巴结清扫术也进行了比较，发现在统计学上相似。无网膜转移组5年OS率为70.6%,有网膜转移组5年OS率为16.2%,分别(p=0.001)。在网膜切除术组中，无网膜转移的5年DFS率为62.2%,有网膜转移的5年DFS率为13.0%(p=0.001)。未切除组5年OS率为86.3%,DFS率为80.0%。
结论：在非子宫内膜样肿瘤中，未进行网膜切除术组的生存率较好.基于这些结果,我们可以说，对于术中目视检查发现网膜正常的非子宫内膜样肿瘤，可能不需要进行网膜切除术。
