Role of omentectomy as part of radical surgery for gastric cancer

Jongerius, Erika J.; Boerma, Djamila; Seldenrijk, Kees A.; Meijer, Sybren L.; Scheepers, Joris J.; Smedts, Frank; Lagarde, Sjoerd M.; Balagué, Olga; Henegouwen, Mark I. van Berge; Sandick, J. W. van; Gisbertz, Suzanne S.

doi:10.1002/bjs.10149

Cited by 53 publications

(54 citation statements)

References 23 publications

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“…These results lead to the idea that if the tumour cells are harboured and proliferate in the greater omentum, they would not be limited to the stomach, the related lymph nodes and the greater omentum but would spread to the unresectable organs or the abdominal cavity. The result of OMEGA trial supports this theory 13 in which resection of the greater omentum did not yield any difference in OS and RFS. In our study, there were also no differences in the first recurrence site after surgery.…”

Section: Discussionsupporting

confidence: 53%

Long-term outcomes of omentum-preserving versus resecting gastrectomy for locally advanced gastric cancer with propensity score analysis

Sakimura

Inaki

Tsuji

et al. 2020

Sci Rep

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Omentectomy is conducted for advanced gastric cancer (AGC) patients as radical surgery without an adequate discussion of the effect. This study was conducted to reveal the impact of omentum-preserving gastrectomy on postoperative outcomes. AGC patients with cT3 and 4 disease who underwent total or distal gastrectomy with R0 resection were identified retrospectively. They were divided into the omentum-preserved group (OPG) and the omentum-resected group (ORG) and matched with propensity score matching with multiple imputation for missing values. Three-year overall survival (OS) and 3-year relapse-free survival (RFS) were compared, and the first recurrence site and complications were analysed. The numbers of eligible patients were 94 in the OPG and 144 in the ORG, and after matching, the number was 73 in each group. No significant difference was found in the 3-year OS rate (OPG: 78.9 vs. ORG: 78.9, P = 0.54) or the 3-year RFS rate (OPG: 77.8 vs. ORG: 68.2, P = 0.24). The proportions of peritoneal carcinomatosis and peritoneal dissemination as the first recurrence site and the rate and severity of complications were similar in the two groups. Omentectomy is not required for radical gastrectomy for AGC.

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Section: Discussionsupporting

confidence: 53%

Long-term outcomes of omentum-preserving versus resecting gastrectomy for locally advanced gastric cancer with propensity score analysis

Sakimura

Inaki

Tsuji

et al. 2020

Sci Rep

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“…This may not be true for gastric cancer invading the greater omentum or if radical resection cannot be achieved without omentectomy. Jongerius and colleagues 27 , in an evaluation of the presence of metastases in the greater omentum after gastrectomy for gastric cancer, showed that more advanced tumour is a risk factor for omental metastasis.…”

Section: Discussionmentioning

confidence: 99%

Gastrectomy with or without omentectomy for cT3–4 gastric cancer: a multicentre cohort study

Nunobe

Honda

et al. 2020

British Journal of Surgery

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Background: Omentectomy is performed widely for locally advanced gastric cancer to prevent disease recurrence. However, its clinical benefit is unknown. Methods: This retrospective cohort study compared the outcome of gastrectomy with preservation of the omentum (GPO) and gastrectomy with resection of the omentum (GRO) among patients with cT3-T4 gastric cancer who underwent gastrectomy between 2006 and 2012 in one of five participating institutions. A consensus conference identified 28 variables potentially associated with outcome after gastrectomy for the estimation of propensity scores, and propensity score matching (PSM) was undertaken to control for possible confounders. Postoperative surgical outcomes, overall survival and disease recurrence were compared between GPO and GRO. Results: A total of 1758 patients were identified, of whom 526 remained after PSM, 263 in each group. Median follow-up was 4⋅9 (i.q.r. 3⋅1-5⋅9) years in the GRO group and 5⋅0 (2⋅5-6⋅8) years in the GPO group. The incidence of postoperative complications of Clavien-Dindo grade III or more was significantly higher in the GRO group (17⋅5 versus 10⋅3 per cent; P = 0⋅016). Five-year overall survival rates were 77⋅1 per cent in the GRO group and 79⋅4 per cent in the GPO group (P = 0⋅749). There were no significant differences in recurrence rate or pattern of recurrence between the groups. Conclusion: Overall survival and disease recurrence were comparable in patients with cT3-4 gastric cancer who underwent GPO or GRO.

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“…Der Grund ist, dass die lokale R0-Resektion zirkumferenziell auch mit Durchtrennung des Netzes transversal in der Mitte sehr sicher erreicht werden kann. Außerdem sind LK-Metastasen im Omentum majus sehr selten [8,12]. Bei AEG-Tumoren kommen LK im rechten Teil des großen Netzes praktisch nicht vor.…”

Section: Double-tract-rekonstruktion Nach Resektion Des Gastroösophagunclassified

Double-Tract-Rekonstruktion nach Resektion des gastroösophagealen Übergangs wegen AEG-II- und -III-Tumoren

et al. 2019

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ZusammenfassungBei selektionierten AEG-Typ-II- und -III-Tumoren (AEG: Adenokarzinome des ösophagogastralen Übergangs) der T-Kategorien 1 und 2 kann der distale Magen nach proximaler Resektion ohne Beeinträchtigung der Radikalität und der Prognose erhalten werden. Als Rekonstruktion wird die Doppeltraktanlage mit Seit-zu-Seit-Anastomosierung des distalen Magens in die Roux-Y-Jejunumschlinge nach Ösophagojejunostomie dargestellt. Nach der Literatur hat dieses Verfahren eine niedrige Rate von postoperativer Refluxösophagitis und erfordert gegenüber der totalen Gastrektomie signifikant geringere Dosen an Vitamin-B12-Substitution, und die Hämoglobinwerte sind signifikant höher.

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Role of omentectomy as part of radical surgery for gastric cancer

Abstract: NCT02050659 ( http://www.clinicaltrials.gov).

Cited by 53 publications

References 23 publications

Long-term outcomes of omentum-preserving versus resecting gastrectomy for locally advanced gastric cancer with propensity score analysis

Long-term outcomes of omentum-preserving versus resecting gastrectomy for locally advanced gastric cancer with propensity score analysis

Gastrectomy with or without omentectomy for cT3–4 gastric cancer: a multicentre cohort study

Double-Tract-Rekonstruktion nach Resektion des gastroösophagealen Übergangs wegen AEG-II- und -III-Tumoren

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