At my surgery I had not done all the research like I have now and did not see how many articles recommended removal of the Omentum-I have shown excerpts about surgical treatment below. I guess at some point I will ask my new oncologist what he thinks bit I would imagine it would be of limited benefit now and is major surgery, I had bilateral and oopharectomy and hysterectomy with 13 pelvic lymph noes negtive but no paras aortic lymph nodes tested - numerous articles I hjave seen lately recomment testing osf para-aortic lymph nodes-the site of my first recurrence. Also I did not have peritoneal washing, as many of the ovarian cancer patients do.
My questions are for USPC patients mainly ?
Did your gynonc discuss removal of the omentum and did any of you have it ?
Did they do peritoneal wash ?
Did they biopsy para-aortic lypmh nodes ?
Did these procedures necessiate abdominal incision as opposed to DaVinci type surgery ?
If you did not, have any of you had discussions with doctors in this arena since surgery (e.g. second surgery as seems to me more common for ovarian) ?
Excepts froma few of the articles":
The primary treatment is surgical. Surgical treatment should consist of, at least, cytologic sampling of the peritoneal fluid, abdominal exploration, palpation and biopsy of suspicious lymph nodes, abdominal hysterectomy, and removal of both ovaries (bilateral salpingo-oophorectomy). Lymphadenectomy, or removal of pelvic and para-aortic lymph nodes, is sometimes performed for tumors that have high risk features, such as pathologic grade 3 serous or clear-cell tumors, invasion of more than 1/2 the myometrium, or extension to the cervix or adnexa. Sometimes, removal of the omentum is also performed.
Abdominal hysterectomy is recommended over vaginal hysterectomy because it affords the opportunity to examine and obtain washings of the abdominal cavity to detect any further evidence of cancer.
Endometrial Carcinoma in its early stages is considered highly curable. The first treatment undertaken is a surgical procedure, particularly if the tumors that have grown exhibit the high-risk features of clear-cell tumors, or pathologic grade 3 serous tumors. This is also true if the cancer has taken up nearly half of cervix extension known as the myometrium. In such cases, omentum removal is also undertaken during surgery.
In some cases, the surgeon may perform abdominal hysterectomy, the surgical removal of the uterus. This surgical method will enable the surgeon to check for any evidence that the cancer has spread to other neighboring tissues.
Treatment of all endometrial cancers begins with surgery, including a total hysterectomy; removal of ovaries, fallopian tubes, and aortic and pelvic lymph nodes; and examination of the abdomen for evidence of extrauterine disease. For UPSC, the surgery may be more extensive, and like the surgical staging of ovarian cancer, it includes removal of the omentum, scrutiny of all peritoneal surfaces for evidence of tumor, excision of all noted disease (“debulking”), and washings and biopsies for pathologic examination. This is an extensive operation that, like many operations for gynecologic cancers, should be performed by a gynecologic oncologist.
Early Uterine Papillary Serous Carcinoma: Primary Treatment Options
(Opens in new window)
When UPSC is confirmed by surgical-pathologic staging to be stage I, standard options for further treatment range from observation to adjuvant chemotherapy and/or radiation therapy.
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