Abstract：
To investigate the risk factors for occult omental metastasis and the effect of omentectomy on the survival of type 2 endometrial cancer (EC) patients. This study enrolled patients who were diagnosed with high-risk (grade 3, serous, clear cell, undifferentiated, carcinosarcoma, or mixed type) EC between 2000 and 2021 and underwent surgery in our center. Data from 482 patients were analyzed retrospectively. Omentectomy was performed in 405 (84.0%) patients. Omental metastases were detected in 61 (12.7%) patients. Eighteen (29.5%) of these metastases were occult. Adnexal involvement, malignant cytology, and peritoneal spread were independent risk factors for omental metastasis. The 5-year overall survival (OS) rate was 59.5% in patients who underwent omentectomy and 64.7% in those who did not (P = 0.558). In patients with and without omental metastases, the overall 5-year OS rates were 34.9% and 63.5%, respectively (P < 0.001). The 5-year OS rates of patients with a normal omentum, gross tumors, and occult metastases were 63.5%, 26.9%, and 52.5%, respectively (P < 0.001). Omental metastases is not uncommon in type II endometrial cancer; approximately one third of patients have occult metastases. Factors - positive cytology, adnexal involvement, and peritoneal involvement are associated with higher probability of omental metastases.
摘要：
探讨2型子宫内膜癌(EC)隐匿性大网膜转移的危险因素及剔除术对患者生存的影响。这项研究招募了被诊断为高风险（3级，浆液，透明细胞,未分化,癌肉瘤,或混合型）EC在2000年至2021年之间，并在我们中心接受了手术。对482例患者的数据进行回顾性分析。405例（84.0%）患者行网膜切除术。61例（12.7%）患者发生脑转移。这些转移中有18例（29.5％）是隐匿的。附体参与，恶性细胞学,腹膜扩散是大网膜转移的独立危险因素。接受网膜切除术的患者的5年总生存率（OS）为59.5％，未接受的患者为64.7％（P=0.558）。在有和没有网膜转移的患者中，总体5年OS率分别为34.9%和63.5%，分别(P<0.001)。正常网膜患者的5年OS率，肉眼肿瘤，隐匿性转移率为63.5%，26.9%,52.5%,分别(P<0.001)。在II型子宫内膜癌中，网膜转移并不少见；大约三分之一的患者有隐匿性转移。因素-细胞学阳性，附件的参与，腹膜受累与大网膜转移的可能性较高有关。
