Article Text

Download PDFPDF
Prognostic Significance of omental Disease and the Role of Omental Sampling in Patients With Uterine Carcinosarcoma
  1. Malcolm Strachan Ross, MD*,
  2. Esther Elishaev, MD,
  3. Jessica Layne Berger, MD*,
  4. Joseph Leo Kelley, MD* and
  5. Sarah Elizabeth Taylor, MD*
  1. *Department of Obstetrics and Gynecology, and
  2. Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
  1. Address correspondence and reprint requests to Malcolm Ross, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Magee-Womens Hospital University of Pittsburgh Medical Center, 300 Halket Street, Pittsburgh, PA 15213. E-mail:


Objectives Uterine carcinosarcomas are an aggressive and rare form of endometrial cancer. Omentectomy is not part of routine staging, but biopsy is often done because omental disease is a known poor prognostic indicator. We sought to define the role of routine omental sampling during surgical staging.

Methods/Materials Patients who underwent staging for uterine carcinosarcoma at our institution from January 2000 to December 2013 were identified. Clinical and pathological data were abstracted. Univariate and multivariable Cox proportional hazard regression analysis was used to identify significant predictors of progression-free (PFS) and overall survival (OS). Logistic regression was used to identify predictors of omental disease.

Results We identified 153 patients. The median age was 65 years (range, 40–87 years), and 88.9% were Caucasian. Omental sampling was performed in 106 (69.3%) patients. Of these, 17(16%) had pathologically confirmed omental disease, and 6 (35.3%) with microscopic disease. On multivariable analysis, tumor size (P = 0.024) and postoperative radiation (P = 0.041) were significant predictors of progression-free survival, and omental disease (P = 0.002), residual disease (P = 0.03), and tumor size (P = 0.025) were significant predictors of OS. Median OS was 11.4 versus 128.7 months for those who did and did not have omental disease, respectively (P <0.001). The median OS for those who had omental sampling (127.7 months) versus those who did not (71.3 months) was not significantly different (P = 0.7432).

Conclusions Although survival was not significantly different between those who did and did not have omental sampling, omental disease had a significant impact on survival. Of those with omental disease, 35% had microscopic disease that could be missed if routine biopsy is not performed, suggesting a role for routine omental sampling.

  • Uterine cancer
  • Uterine carcinosarcoma
  • Omentectomy
  • Omental sampling

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • The authors declare no conflicts of interest.