PDF(Pubmed)
Abstract：
Negine PaulIntroduction Traditionally, the concept of complete omentectomy during gastric resection for cancer was based on lymphatic drainage and the occurrence of occult omental metastasis (OM). However, recent emerging evidence has challenged this concept of complete omentectomy. We, therefore, aim to find the incidence and risk factors of occult OM and also evaluate the outcome of patients with and without such metastasis. Methods This is a single institutional, retrospective study of patients with gastric cancer who underwent curative radical gastrectomy for a period of 3 years (April 1, 2016, to March 31, 2019). A complete omentectomy was performed in all patients and the omentum and nodal stations were dissected in the resected specimen and sent for pathological analysis. Clinical and epidemiological data were collected from the hospital patient database and analysis was done. Results A total of 185 patients have been included in the study, with a mean age of 53.84 years. Twenty of the 185 patients had OM (10.8%). Age, sex, location of the tumor, and neoadjuvant chemotherapy were not statistically significant in predicting OM. However, tumor size and tumor depth were found to have a significant association with OM. The occurrence of OM was more likely to be associated with disease recurrence, especially in the peritoneum. The mean overall survival was 38.15 months (±3.33 SD), whereas patients with OM had lower survival, 23.31 months (±7.79 SD), with a p -value of 0.012. Conclusion OM was not encountered in T1 and T2 gastric cancers and the incidence of OM in T3 and T4 tumors was approximately 12.7%. Therefore, complete omentectomy may be omitted in early T1/T2 tumors. OM was associated with poor prognosis, increased peritoneal recurrence, and decreased overall survival, in spite of a complete omentectomy, and may serve as a prognostic indicator for disease recurrence and overall survival.
摘要：
NeginePaulIntroduction传统上，胃癌切除术中完整网膜切除术的概念是基于淋巴引流和隐匿性网膜转移（OM）的发生。然而,最近出现的证据对完全网膜切除术的概念提出了挑战.我们,因此,目的了解隐匿性OM的发生率和危险因素，并评估有和无转移患者的预后。方法这是一个单一的机构，回顾性研究接受根治性胃癌根治术3年（2016年4月1日至2019年3月31日）的胃癌患者。所有患者均进行了完整的网膜切除术，并在切除的标本中解剖了网膜和淋巴结，并送去进行病理分析。从医院患者数据库中收集临床和流行病学数据并进行分析。结果共纳入185例患者,平均年龄53.84岁.185例患者中有20例患有OM（10.8%）。年龄,性别,肿瘤的位置，和新辅助化疗在预测OM方面无统计学意义。然而,发现肿瘤大小和肿瘤深度与OM显著相关.OM的发生更可能与疾病复发有关，尤其是在腹膜里.平均总生存期为38.15个月（±3.33SD），而OM患者的生存率较低，23.31个月（±7.79标准差），p值为0.012。结论T1和T2胃癌未出现OM，T3和T4肿瘤中OM的发生率约为12.7％。因此,在T1/T2早期肿瘤中可以省略完整的网膜切除术。OM与不良预后相关，腹膜复发增加，总生存率下降，尽管做了完整的网膜切除术,并可作为疾病复发和总生存期的预后指标。
