Department of Anus and Intestine Surgery, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China.
The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
World J Surg Oncol. 2024 Sep 6;22(1):236. doi: 10.1186/s12957-024-03521-3.
The effect of omentum preservation (OP) on locally advanced gastric cancer (LAGC) remains controversial. This study aimed to investigate the long-term prognosis of LAGC patients with OP versus omentum resection (OR).
A comprehensive search of databases including PubMed, Web of Science, Embase, and Cochrane Library was conducted up until February 2024. Statistical analysis was performed using Stata 12.0 software. The primary outcome was to assess the impact of OP on the long-term prognosis of patients with LAGC, including overall survival (OS) and recurrence-free survival (RFS).
A total of six case-control studies were included, encompassing a cohort of 1897 patients. The OP group consisted of 844 patients, while the OR group comprised 1053 patients. The study results showed that the OS (HR = 0.72, 95% CI: 0.58-0.90, P = 0.003) and 5-year RFS (HR = 0.79, 95% CI: 0.63-0.99, P = 0.038) in the OP group were superior to those observed in the OR group. Subgroup analysis indicated that 5-year OS (HR = 0.64, P = 0.003) and 5-year RFS (HR = 0.69, P = 0.005) in the OP group were also better than those in the OR group in Korea. However, the subgroup analysis conducted on stage T3-T4 tumors revealed no statistically significant differences in OS (P = 0.083) and 5-year RFS (P = 0.173) between the two groups.
Compared with OR, OP shows non-inferiority in patients with LAGC and can be considered a potential treatment option for radical gastrectomy.
网膜保存（OP）对局部进展期胃癌（LAGC）的影响仍存在争议。本研究旨在探讨 LAGC 患者行网膜保留（OP）与网膜切除（OR）的长期预后。
对包括 PubMed、Web of Science、Embase 和 Cochrane Library 在内的数据库进行全面检索，检索时间截至 2024 年 2 月。采用 Stata 12.0 软件进行统计学分析。主要结局指标是评估 OP 对 LAGC 患者长期预后的影响，包括总生存（OS）和无复发生存（RFS）。
共纳入 6 项病例对照研究，包含 1897 例患者。OP 组 844 例，OR 组 1053 例。研究结果显示，OP 组的 OS（HR=0.72，95%CI：0.58-0.90，P=0.003）和 5 年 RFS（HR=0.79，95%CI：0.63-0.99，P=0.038）均优于 OR 组。亚组分析显示，OP 组的 5 年 OS（HR=0.64，P=0.003）和 5 年 RFS（HR=0.69，P=0.005）也优于韩国的 OR 组。然而，对 T3-T4 期肿瘤进行的亚组分析显示，两组在 OS（P=0.083）和 5 年 RFS（P=0.173）方面无统计学差异。
与 OR 相比，OP 在 LAGC 患者中表现出非劣效性，可作为根治性胃切除术的一种潜在治疗选择。
