# Impact of diagnostic peritoneal lavage on omentum metastasis

> **NIH NIH R03** · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2021 · $81,000

## Abstract

PROJECT SUMMARY/ABSTRACT
The omentum is an immune cell-rich fatty tissue that suspends from the stomach and plays an important role in
peritoneal defense. The omentum is the predominant site of ovarian cancer metastasis, and metastasis to the
omentum can lead to fatal bowel obstruction. Although surgical removal of the omentum has been advocated
for cancer patients who do not present with overt omental metastasis, this prophylactic procedure has been
contentious. The over-arching goal of this study is to identify approaches to minimize the risk of omental
metastasis by occult circulating cancer cells when the omentum is preserved. Peritoneal lavage is a diagnostic
procedure that is performed as part of abdominal cancer staging in which saline solution is administered into
the peritoneal cavity and the washings are cytologically examined. Saline solution has also been widely used
for i.v. fluid and electrolyte replenishment. Studies of infusion in the critical care setting have shown that the
main adverse effect of saline solution is hyperchloremic acidosis, and there is evidence that acidosis can
activate inflammatory responses that foster a cancer-permissive milieu. Because the omentum has immense
capability to absorb fluid in the peritoneal cavity, we speculate that the omentum might be deleteriously
affected by peritoneal lavage with saline solution. Based on these prior reports and our preliminary studies, we
hypothesize that peritoneal lavage with saline solution stimulates the omentum to become conducive for
implantation of occult cancer cells. In this study, we will evaluate the impact of peritoneal lavage with saline
solution on cellular constituents of the omentum and inflammatory responses, and determine whether this
lavage stimulates implantation of circulating cancer cells on the omentum in mouse allograft models of ovarian
cancer. Importantly, we will also determine whether the risk of omental metastasis can be minimized by using
buffered solutions instead of saline for peritoneal lavage. If successful, our study will provide a new and
important rationale for revising diagnostic and staging practices to reduce the risk of metastasis to the
omentum when this site is preserved.

## Key facts

- **NIH application ID:** 10286303
- **Project number:** 1R03CA255193-01A1
- **Recipient organization:** UNIVERSITY OF TX MD ANDERSON CAN CTR
- **Principal Investigator:** Honami Naora
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $81,000
- **Award type:** 1
- **Project period:** 2021-07-08 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10286303

## Citation

> US National Institutes of Health, RePORTER application 10286303, Impact of diagnostic peritoneal lavage on omentum metastasis (1R03CA255193-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10286303. Licensed CC0.

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