Comparison of Omental Biopsy and Peritoneal Washings on Postoperative Adjuvant
Therapy in Clinical Stage 1 Endometrial Carcinoma
Drs.  P. Hogston *, J. Nieto, R. Woolas
St. Mary’s Hospital
Portsmouth, United Kingdom

Background: Full surgical staging for endometrial cancer requires pelvic and para-aortic lympadenectomy and peritoneal washings. Fifty percent of patients may not be suitable for such a procedure due to poor performance status. Decisions on post-operative therapy are therefore taken on the basis of high risk pathological features of the excised specimen.
Objective: We have previously reported the influence of omental biopsy on adjuvant treatment fields. In the present study 80 consecutive patients with endometrial cancer had peritoneal washings and an omental biopsy performed. The information obtained from these tests was compared.
Results: 6 patients had a positive omental biopsy and 2 positive peritoneal washings. Eight patients had ovarian metastases. Of the 6 patients with a positive omental biopsy both had positive peritoneal washings.
Conclusions: Peritoneal washings did not give additional information over omental biopsy and pathological examination of the uterus and adnexae. The significance of positive peritoneal washings in endometrial cancer is uncertain. Furthermore, treatment of such patients is undecided. Omental biopsy is proof of extra pelvic disease for negligible risk and similar laboratory time. It gives more information than peritoneal washings and might influence the prescription of adjuvant pelvic radiotherapy.