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

Sakimura, Yusuke; Inaki, Noriyuki; Tsuji, Toshikatsu; Kadoya, Shinichi; Bando, Hiroyuki

doi:10.1038/s41598-020-73367-8

Cited by 23 publications

(52 citation statements)

References 36 publications

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“…Furthermore, several retrospective studies showed that OPG does not increase the recurrence rate and worsen the survival of patients with GC compared with GCO (3, 5, 10). Sakimura Y et al (11) reported that the recurrence rates of OPG and GCO groups are not different and that omentectomy is not required for radical gastrectomy. Seo WJ et al (5) and Ri M et al (10) reported no survival difference between OPG and GCO in patients with GC.…”

Section: Discussionmentioning

confidence: 99%

“…The primary outcome of this study was the assessment of the RFS rate of OPG in patients with GC. Ultimately, three studies (3,9,11) reported the 3-year RFS rates, and the meta-analysis of pooled analysis showed no significant difference in the 3-year RFS rate between OPG and GCO groups (OR = 1.40, 95% CI = 0.86 to 2.27, p = 0.18) (Figure 5C). Four studies (3,5,8,10) reported the 5-year RFS rates, and the meta-analysis of pooled analysis showed that the 5-year RFS rates of the two groups were similar (OR = 1.21, 95% CI = 0.95 to 1.55, p = 0.12) (Figure 5D).…”

Section: Oncological Outcomesmentioning

confidence: 99%

“…Seven studies (4, 5, 7-10, 12) reported the number of retrieved lymph nodes of both groups, and the difference between the two groups was not statistically significant (MD = 2.16, 95% CI = −0.61 to 4.93, P = 0.13) (Figure 4C). Seven studies (3)(4)(5)(9)(10)(11)(12) reported the postoperative complications of both groups, and no significant difference between the OPG and GCO groups was observed (OR = 0.92, 95% CI = 0.74 to 1.15, p = 0.47) (Figure 4D).…”

Section: Surgical Outcomesmentioning

confidence: 99%

“…A total of 920 studies were identified. Nine studies (3)(4)(5)(7)(8)(9)(10)(11)(12), including 8 retrospective studies and 1 randomized controlled trial, were ultimately included in this meta-analysis. Three multicenter studies were obtained.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Six studies (3,5,(8)(9)(10)(11) reported the overall recurrence rates, and five studies (3,5,(9)(10)(11) reported the peritoneal recurrence rates.…”

Section: Oncological Outcomesmentioning

confidence: 99%

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Efficacy of Omentum-Preserving Gastrectomy for Patients With Gastric Cancer: A Systematic Review and Meta-Analysis

Song

Zhou

et al. 2021

Front. Oncol.

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BackgroundComplete omentectomy is considered to be essential in the radical gastrectomy for gastric cancer (GC), but its clinical benefit remains unclear. This study aims to evaluate the efficacy of omentum-preserving gastrectomy (OPG) for patients with GC.MethodsStudies comparing the surgical and oncological outcomes of OPG and gastrectomy with complete omentectomy (GCO) for GC up to March 2021 were systematically searched from PubMed, Web of Science, Embase, and Cochrane Library. A pooled analysis was performed for the available data regarding the baseline features, surgical and oncological outcomes. The RevMan 5.3 software was used to perform the statistical analysis. Quality evaluation and publication bias were also conducted.ResultsNine studies with a total of 3335 patients (1372 in the OPG group and 1963 in the GCO group) undergoing gastrectomy were included. In the pooled analysis, the baseline data in two groups were all comparable (p > 0.05). However, the OPG group was associated with shorter operative time (MD = −18.67, 95% CI = −31.42 to −5.91, P = 0.004) and less intraoperative blood loss (MD = −38.09, 95% CI = −53.78 to −22.41, P < 0.00001) than the GCO group. However, the number of dissected lymph nodes (MD = 2.16, 95% CI = −0.61 to 4.93, P = 0.13), postoperative complications (OR = 0.92, 95% CI = 0.74 to 1.15, p = 0.47), overall recurrence rate (OR = 0.83, 95% CI = 0.66 to 1.06, p = 0.14), peritoneal recurrence rate (OR = 0.91, 95% CI = 0.65 to 1.29, p = 0.60), 3-year relapse-free survival (RFS) rate (OR = 1.40, 95% CI = 0.86 to 2.27, p = 0.18), and 5-year RFS rate (OR = 1.21, 95% CI = 0.95 to 1.55, p = 0.12) of the two groups were comparable.ConclusionsOPG might be an oncologically safe procedure with better surgical outcomes for patients with GC than GCO. However, high-quality randomized controlled trials are needed to confirm this benefit.

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Section: Discussionmentioning

confidence: 99%

Section: Oncological Outcomesmentioning

confidence: 99%

Section: Surgical Outcomesmentioning

confidence: 99%

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Six studies (3,5,(8)(9)(10)(11) reported the overall recurrence rates, and five studies (3,5,(9)(10)(11) reported the peritoneal recurrence rates.…”

Section: Oncological Outcomesmentioning

confidence: 99%

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Efficacy of Omentum-Preserving Gastrectomy for Patients With Gastric Cancer: A Systematic Review and Meta-Analysis

Song

Zhou

et al. 2021

Front. Oncol.

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What are the short‐ and long‐term abdominal consequences of an omentectomy? A systematic review

Smit,

Plat,

Panday

et al. 2024

Journal of Surgical Oncology

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This review provides an overview regarding the abdominal effects of an omentectomy, with or without extra‐peritoneal reconstructions. In general, reported complication rates were low. Short‐term complications involved ileus, bowel stenosis, abdominal abscess and sepsis (range 0.0%–23%). Donor‐site hernia was mainly reported as long‐term complication (up to 32%) and negligible gastrointestinal complications were observed. However, the level of evidence and methodological quality are quite low with a maximum of 8.5 years follow‐up.

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Overall Survival Advantage of Omentum Preservation Over Omentectomy for Advanced Gastric Cancer: A Systematic Review and Meta‐Analysis

Kong

Chen

Zhang³

et al. 2022

World j. surg.

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Background Since 1910, omentectomy has been an essential component of radical gastrectomy for advanced gastric cancer. However, researchers have recently questioned the benefit of omentectomy in radical gastrectomy. The aim of this meta-analysis was to compare omentectomy and omentum preservation in gastrectomy for advanced gastric cancer in terms of survival outcomes and short-term outcomes. Methods The PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched. Studies that compared omentum preservation with omentectomy were included. Overall survival (OS) and relapse-free survival (RFS) were analyzed as primary outcomes. Results Of 3509 records screened, one randomized clinical trial and five propensity-score matched retrospective studies with 1661 patients were selected. Omentum preservation was associated with improved OS (hazard ratio [HR] = 0.757, 95% confidence interval [CI] = 0.603-0.950, P = 0.016, I 2 = 0%), but not with improved RFS (HR = 0.821, 95% CI = 0.668-1.009, P = 0.060, I 2 = 9%) compared with omentectomy for advanced gastric cancer. Furthermore, less blood loss and shorter operation time were found in the omentum preservation group than in the omentectomy group. Additionally, the rate of peritoneal recurrence, the number of harvested lymph nodes, and the incidences of postoperative complications and ileus were comparable in the two groups. Conclusions Basing on the current literature, gastrectomy with omentum preservation was associated with improved OS and short-term outcomes compared with omentectomy for advanced gastric cancer. Further randomized trials are required to confirm the survival benefit of omentum-preserving gastrectomy.

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

Cited by 23 publications

References 36 publications

Efficacy of Omentum-Preserving Gastrectomy for Patients With Gastric Cancer: A Systematic Review and Meta-Analysis

Efficacy of Omentum-Preserving Gastrectomy for Patients With Gastric Cancer: A Systematic Review and Meta-Analysis

What are the short‐ and long‐term abdominal consequences of an omentectomy? A systematic review

Overall Survival Advantage of Omentum Preservation Over Omentectomy for Advanced Gastric Cancer: A Systematic Review and Meta‐Analysis

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