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Abstract
Review
Highlights
- •
- The role of the omentum in the human body remains incompletely understood.
- •
- The omentum serves as a reservoir of immune cells in the peritoneal cavity.
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- There is conflicting data from animal models as to whether the omentum prevents or promotes cancer.
Objective
This
article reviews the literature concerning the function of the omentum
and how it came to be part of the staging and treatment of epithelial
ovarian cancer.
Methods
A review
of the English language literature based on a MEDLINE (PubMed) database
search using the key words: ovary, cancer, carcinoma, omentum, and
omentectomy. An additional collection of reports was found by
systematically reviewing all references from retrieved papers.
Results
Descriptions
of the omentum can be found as far back as the time of the ancient
Egyptians. An immunologic role of the omentum was confirmed in 1980s
when “milky spots” were described. Omentectomy arrived as part of the
ovarian cancer guidelines in the 1960s after observing that the omentum
was a frequent site of metastasis and that patients with removal of all
diseased tissue did better. The exact role of the omentum in immunology
and cancer remains incompletely understood.
Conclusions
Historically,
occult omental metastases in otherwise early disease have led to the
inclusion of omentectomy for the purpose of accurate staging and for a
possible therapeutic benefit. Laboratory studies on the role in cancer
of the omental fat and milky spots are controversial.
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