Researchers recommend against complete omentectomy for resectable gastric cancer
Patients who underwent complete omentectomy for gastric cancer had decreased overall survival rates compared with patients who underwent non-complete omentectomy, according to research published in BMC Gastroenterology.
“Although many treatment modalities have validated efficacy in gastric cancer (GC), radical gastrectomy remains the mainstay of curative treatment for GC. Radical gastrectomy should be performed whenever possible,” Akao Zhu, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, and colleagues wrote. “However, the extent of radical gastrectomy for GC has not reached a consensus. For example, although commonly performed, the efficiency of complete omentectomy (CO) during radical gastrectomy has not yet been universally acknowledged.”
To investigate the current evidence on the clinical value of CO, researchers performed a meta-analysis and systematic review of nine studies composed of 3,329 patients who underwent either CO (1,960) or non-CO ([NCO] 1,369). Using relative risks and weighted mean differences (WMD) they compared overall survival (OS) rates, relapse-free survival (RFS) rates and recurrence rates between both procedure groups. Secondary endpoints included surgical-related outcome comparisons and postoperative recovery outcome comparisons.
According to study results, CO correlated with a lowered 3-year OS rate (RR = 0.94; 95% CI, 0.9-0.98) and 5-year OS rate (RR = 0.93; 95% CI, 0.88-0.98) compared with NCO. Researchers observed no significant difference between CO and NCO regarding 3-year RFS rates (RR = 0.97; 95% CI, 0.9-1.04), 5-year RFS rate (RR = 0.98; 95% CI, 0.9-1.06) or recurrence rate (RR = 1.17; 95% CI, 0.95-1.45). Among surgical-related outcomes, CO correlated with increased estimated blood loss (WMD = 250.9; 95% CI, 105.9-396.28) and decreased harvested lymph nodes (WMD = –3.59; 95% CI, –6.88 to –0.29). They noted no significant difference in the rates for overall complications, major complications or lengths of hospital stays.
“CO did not benefit survival, operative or recovery outcomes when compared with NCO. Based on the available evidence, CO is not recommended as a standard procedure for resectable gastric cancer,” Zhu and colleagues concluded. “Future well-designed, high-quality randomized controlled trials are warranted to clarify the efficacy of CO in radical gastrectomy, especially in cT3 or cT4 gastric cancer.”
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