Abstract：
BACKGROUND: 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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
背景：胃癌的治疗通常包括围手术期化疗联合根治性（R0）胃切除术。除了改良的D2淋巴结肿大，建议进行完整的网膜切除术.然而,几乎没有证据表明网膜切除术对生存有益.本研究提供了OMEGA研究的后续数据。
方法：这项多中心前瞻性队列研究纳入了100例连续胃癌患者，这些患者接受了（次）全胃切除术，包括完整的整体网膜切除术和改良的D2淋巴结切除术。本研究的主要结果是5年总生存率。比较有无网膜转移的患者。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：在纳入的100名患者中，5人在大网膜有转移.有网膜转移的患者的五年总生存率为0.0％，无网膜转移的患者为44.2％（p=0.001）。有或没有网膜转移的患者的中位总生存时间为7个月和53个月。在没有网膜转移的患者中，（y）pT3-4期肿瘤和血管侵袭性生长与局部复发和/或转移有关。
结论：在接受潜在治愈性手术的胃癌患者中，大网膜转移的存在与总生存期受损相关。在未发现网膜转移的情况下，作为胃癌根治性胃切除术的一部分的网膜切除术可能不会对生存带来好处。
方法：这项多中心前瞻性队列研究纳入了100例连续胃癌患者，这些患者接受了（次）全胃切除术，包括完整的整体网膜切除术和改良的D2淋巴结切除术。本研究的主要结果是5年总生存率。比较有无网膜转移的患者。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：在纳入的100名患者中，5人在大网膜有转移.有网膜转移的患者的五年总生存率为0.0％，无网膜转移的患者为44.2％（p=0.001）。有或没有网膜转移的患者的中位总生存时间为7个月和53个月。在没有网膜转移的患者中，（y）pT3-4期肿瘤和血管侵袭性生长与局部复发和/或转移有关。
结论：在接受潜在治愈性手术的胃癌患者中，大网膜转移的存在与总生存期受损相关。在未发现网膜转移的情况下，作为胃癌根治性胃切除术的一部分的网膜切除术可能不会对生存带来好处。
