The relationship between clinicopathology factors and omental metastasis in epithelial ovarian cancer

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Sigit Purbadi
Hariyono Winarto
Febian Nathania


Clinicopathology factors; epithelial ovarian cancer; omentum; omental metastasis


Background: Aside from being a major metastatic site in epithelial type ovarian cancer, omentum has an immunological role. Omentum has the ability to colonize the spread of cancer cells by forming omental caking. This study aims to determine the relationship between clinicopathology factors with metastasis in omentum in epithelial type ovarian cancer.

Methods: The study used cross-sectional study design. Subjects were patients diagnosed with epithelial type ovarian cancer who underwent surgery at Cipto Mangunkusumo Hospital between January 2010 and December 2017.

Results: There was an association between serous as well as mucinous type, omental nodules, and between CA 125 and metastasis in omentum (OR 1.7, CI 95% 24.1-47.7; p = 0.002, OR 14.5, CI 95% 2.5- 82.2; p = 0.002, OR 61, CI 95% 11.4-324.8; p <0.01, and OR 3.5, CI 95% 1.2-9.7; p = 0.013). Multivariate analysis demonstrated a significant association between mucinous types with metastases in the omentum (aOR 9.71, CI 95% 1.11-84.89; p = 0.04) and between the omental nodules and metastases in the omentum (aOR 40.92, CI 95% 6.64-251.96 ; p <0.01).

Conclusion: The incidence of omental metastasis in epithelial ovarian cancer is higher in mucinous histological types of and omental nodules only.

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1.Bethesda. SEER Cancer Statistics Factsheets: Ovary Cancer: National Cancer Institute; 2015 [26 Maret 2018]. Available from:
2.Inasgo. National Data Jakarta2018 [Maret 2018]. Available from:
3.Inasgo. Cancer registration information system: National data Jakarta2017 [11 April 2018]. Available from:
4.Soto AEG, Boren T, Wingo SN, Heffernen T, Miller DS. Is comprehensive surgical staging needed for thorough evaluation of early- stage ovarian carcinoma? American Journal of Obstetrics and Gynecology. 2012;206:2421-5.
5.Usubütün AMD, Ozseker HSMD, Himmetoglu CMD, Balci SMD, Ayhan AMD. Omentectomy for gynecologic cancer: How much sampling is adequate for microscopic examination? Archives of Pathology & Laboratory Medicine. 2007;131(10):1578-81.
6.Ahyan A, Gultekin M, Celik NY, Dursun P, Taskiran C, Aksan G, et al. Occult metastasis in early ovarian cancer: Risk factor and associated prognosis. American Journal of Obstetrics and Gynecology. 2007(196):811-6.
7.Arie AB, McNally L, Kapp DS, Teng NNH. The omentum and omentectomy in epithelial ovarian cancer: A reappraisal: Part II — The role of omentectomy in the staging and treatment of apparent early stage epithelial ovarian cancer. Gynecologic Oncology. 2013;131(3):784-90.
8.Horvath LE, Werner T, Boucher K, Jones K. The relationship between tumor size and stage in early versus advanced ovarian cancer. Medical Hypotheses. 2013;80:684–7.
9.Hennessy BT, Coleman RL, Markman M. Ovarian cancer. The Lancet. 2009;374(9698):1371-82.
10.Berek, Novak. Ovarian and fallopian tube cancer. In: Berek JS, editor. Berek and Novak's Gynecology. 14 ed: Lippincott Williams and Wilkins; 2007. p. 1457-503.
11.Arie AB, McNally L, Kapp DS, Teng NNH. The Omentum and omentectomy in epithelial ovarian cancer: A reappraisal Part I - Omental function and history of omentectomy. Gynecologic Oncology. 2013;131(3):780-3.
12.Le T, Adolph A, Krepart G, Lotocki R, Heywood M. The benefits of comprehensive surgical staging in management of early stage epithelial ovarian carcinoma. Gynecology Oncology. 2002;85:351-5.
13.Aletti GD, Gallenberg MM, Cliby WA, Jatoi A, Hartmann LC. Current management strategies for ovarian cancer. Mayo Clinic Proceedings. 2007;82(6):751-70.
14.Mebius RE. Lymphoid organs for peritoneal cavity immune response: milky spots. Immunity. 2009;30(5):670-2.
15.White EA, Kenny HA, Lengyel E. Three-dimensional modeling of ovarian cancer. Advanced Drug Delivery Reviews. 2014.
16.Clark R, Krishnan V, Schoof M, Rodriguez I, Theriault B, Chekmareva M, et al. Milky spots promote ovarian cancer metastatic colonization of peritoneal adipose in experimental models. The American Journal of Pathology. 2013;183(2):576-91.
17.Doig T, Monaghan H. Sampling the omentum in ovarian neoplasia: when one block is enough. Int J Gynecol Cancer 2006;16:36-40.
18.Lengyel E. Ovarian cancer development and metastasis. The American Journal of Pathology. 2010;177(3):1053-64.
19.Erickson BK, Conner MG, Landen CN. The role of the fallopian tube in the origin of ovarium cancer. American Journal of Obstetrics & Gynecology. 2013;209(5):409-14.
20.Kurman RJ, Shih LM. The origin and pathogenesis of epithelial ovarian cancer a proposed unifying theory. Am J Surg Pathol. 2010;34(3):433-43.
21.Tan DSP, Agarwal R, Kaye SB. Mechanisms of transcoelomic metastasis in ovarian cancer. The Lancet Oncology. 2006;7(11):925-34.
22.Kuhn E, Ayhan A, Shih L-M, Seidman JD, Kurman RJ. Ovarian brenner tumor: A morphologic and immunohistochemical analysis suggesting an origin from fallopian tube epithelium. European Journal of Cancer. 2013;49:3839-49.
23.Moore KL, Agur AM. Pelvis dan perineum. In: Sadikin V, Saputra V, editors. Anatomi Klinis Dasar. Jakarta: Penerbit Hipokrates; 2002. p. 171-3.
24.Blom, Fawcett. Jaringan penyambung. In: Hartanto H, editor. Buku ajar histologi. Jakarta: EGC; 2002. p. 143-7.
25.Okugawaa K, Hirakawaa T, Fukushimaa K, Kamurab T, Amadaa S, Nakanoa H. Relationship between age, histological type, and size of ovarian tumors. International Journal of Gynecology & Obstetrics 2001;74:45-50.
26.Usubütün A, Ozseker HS, Himmetoglu C, Balcı S, Ayhan A. Omentectomy for gynecologic cancer: How much sampling is adequate for microscopic examination? Archives of Pathology & Laboratory Medicine. 2007;131(10):1578-81.
27.Shield K, Ackland ML, Ahmed N, Rice GE. Multicellular Spheroids in Ovarian Cancer Metastases: Biology and Pathology. Gynecology Oncology. 2009;113:143-8.
28.Gupta D, Lis CG. Role of CA125 in predicting ovarian cancer survival - a review of the epidemiological literature. Journal of Ovarian Research 2009;2(13).
29.Scholler N, Urban N. CA125 in Ovarian Cancer. Biomark Med. 2007;1(4):513-23.
30.Yuan Q, Song J, Yang W, Wang H, Huo Q, Yang J, et al. The effect of CA125 on metastasis of ovarian cancer: old marker new function. Oncotarget. 2017;8(30):50015-22.

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