Omentectomy as Part of Radical Surgery for Gastric Cancer: 5-Year Follow-Up Results of a Multicenter Prospective Cohort Study.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Digestive Surgery Pub Date : 2023-01-01 DOI:10.1159/000530975

Kammy Keywani, Alexander B J Borgstein, Djamila Boerma, Stijn van Esser, Wietse J Eshuis, Mark I Van Berge Henegouwen, Johanna van Sandick, Suzanne S Gisbertz

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Abstract

Introduction: Curative therapy for gastric cancer usually consists of perioperative chemotherapy combined with a radical (R0) gastrectomy. In addition to a modified D2 lymphadenectomy, a complete omentectomy is recommended. However, there is little evidence for a survival benefit of omentectomy. This study presents the follow-up data of the OMEGA study.

Methods: This multicenter prospective cohort study included 100 consecutive patients with gastric cancer undergoing (sub)total gastrectomy with complete en bloc omentectomy and modified D2 lymphadenectomy. Primary outcome of the current study was 5-year overall survival. Patients with or without omental metastases were compared. Pathological factors associated with locoregional recurrence and/or metastases were tested with multivariable regression analysis.

Results: Of 100 included patients, five had metastases in the greater omentum. Five-year overall survival was 0.0% in patients with omental metastases and 44.2% in patients without omental metastases (p = 0.001). Median overall survival time for patients with or without omental metastases was 7 months and 53 months. A (y)pT3-4 stage tumor and vasoinvasive growth were associated with locoregional recurrence and/or metastases in patients without omental metastases.

Conclusion: The presence of omental metastases in gastric cancer patients who underwent potentially curative surgery was associated with impaired overall survival. Omentectomy as part of radical gastrectomy for gastric cancer might not contribute to a survival benefit in case of undetected omental metastases.

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网膜切除术作为胃癌根治性手术的一部分:一项多中心前瞻性队列研究的5年随访结果

导言:胃癌的根治性治疗通常包括围手术期化疗联合根治性胃切除术。除改良D2淋巴结切除术外，建议行全网膜切除术。然而，很少有证据表明网膜切除术对生存有好处。本研究提供OMEGA研究的随访数据。方法:这项多中心前瞻性队列研究包括100例连续接受(亚)全胃切除术、全网膜切除术和改良D2淋巴结切除术的胃癌患者。目前研究的主要终点是5年总生存率。对有或无大网膜转移的患者进行比较。用多变量回归分析检测与局部复发和/或转移相关的病理因素。结果:100例患者中，5例转移至大网膜。大网膜转移患者的5年总生存率为0.0%，无大网膜转移患者的5年总生存率为44.2% (p = 0.001)。有或没有大网膜转移的患者中位总生存时间分别为7个月和53个月。A (y)pT3-4期肿瘤和血管侵袭性生长与没有大网膜转移的患者的局部复发和/或转移有关。结论:在接受有可能治愈的手术的胃癌患者中出现大网膜转移与总生存期受损有关。在未发现大网膜转移的情况下，作为胃癌根治性胃切除术的一部分，大网膜切除术可能不会对生存有利。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.