The evaluation of the omentum in ovarian cancer

Little published data exists on omental evaluation in ovarian cancer. In a retrospective study we reviewed 334 consecutive operations for adnexal masses; 159 had ovarian cancer, and 119 omentectomies were performed, with complete information available on 109. Mean omentectomy was 203.5 cm2 (normal omentum = 792 cm2) and 190 g, with a significant correlation of weight to size. Secondary ovarian cancer was present in 66 omenta (61%). All 32 omenta examined in the pathology laboratories and described as grossly involved with tumor had ovarian cancer histologically. Of the 55 grossly negative omenta, 12 had histologically proven tumor (22%). Slide review of the grossly negative, histologically positive omenta revealed the mean tumor diameter to measure 6.7 mm. Lymph node dissection occurred in 16 patients and was positive in 10, with simultaneous absence of tumor in the omenta of 3 of these patients. Conversely, 2 patients with positive omenta had negative lymph nodes. The optimal extent of omental resection and histological examination remains undetermined.