Whether or not a junctional ovarian tumor requires removal of the greater omentum needs to be decided based on staging; if it is early to mid-stage it needs to be removed, if it is advanced it does not.
In patients with stage I junctional tumors and no fertility needs, total uterus, both ovaries, fallopian tubes, as well as resection of the greater omentum and any lesions suspicious to the naked eye under the transverse colon are resected at the time of full staging, and unilateral adnexal resection with full staging is feasible in patients with fertility needs.
Tumor cytoreduction is required in intermediate to advanced patients with extraovarian metastases assessed preoperatively or intraoperatively, in which the entire uterus, double adnexa, greater omentum and all tumors visible to the naked eye are removed.
In patients who are advanced and unfit for surgery as well as those with recurrence who undergo laparoscopic exploratory surgery, re-reduced tumor cytoreduction, and adjuvant palliative surgery, the greater omentum does not need to be excised.
Patients with junctional ovarian cancer should choose the appropriate treatment according to the specific situation and the doctor’s advice.