Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, 920-8530, Japan.
Department of Surgery, Juntendo University Urayasu Hospital, Chiba, 279-0021, Japan.
Sci Rep. 2020 Oct 1;10(1):16305. doi: 10.1038/s41598-020-73367-8.
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.
网膜切除术在没有充分讨论效果的情况下被用于治疗进展期胃癌（AGC）患者的根治性手术。本研究旨在揭示保留网膜与不保留网膜的胃癌根治术对术后结果的影响。回顾性分析了接受全胃或远端胃切除术且 R0 切除的 cT3 和 4 期 AGC 患者。将其分为保留网膜组（OPG）和切除网膜组（ORG），并采用倾向性评分匹配和多重插补法处理缺失值。比较两组患者的 3 年总生存（OS）率和 3 年无复发生存（RFS）率，并分析首次复发部位和并发症。OPG 组和 ORG 组分别有 94 例和 144 例符合条件的患者，匹配后每组各有 73 例患者。两组患者的 3 年 OS 率（OPG：78.9% vs. ORG：78.9%，P=0.54）和 3 年 RFS 率（OPG：77.8% vs. ORG：68.2%，P=0.24）均无显著差异。两组首次复发部位为腹膜转移和腹膜播散的比例、并发症的发生率和严重程度相似。对于 AGC 的根治性胃切除术，网膜切除术并非必需。
