Biying Huang, Chih-Han Kung, Andrianos Tsekrekos, Fredrik Klevebro, Raphaela Mayerhofer, Laura Vossen Engblom, Mats Lindblad, Jakob Hedberg, Eva Szabo, David Edholm, Ulrika Smedh, Jan Johansson, Ioannis Rouvelas, Magnus Nilsson
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The primary endpoint was overall survival assessed by a multivariable Cox proportional hazards model, adjusted for age, sex, American Society of Anesthesiologists physical status score, clinical T and N stage, type of gastrectomy, surgical approach, extent of lymphadenectomy, neoadjuvant chemotherapy, surgery year and regional cancer centre. Secondary endpoints were surgical outcomes including tumour-free resection margins, lymph node yield and postoperative complications.</p><p><strong>Results: </strong>A total of 1615 patients were included, 517 (32.0%) underwent gastrectomy with omental preservation, and 1098 (68.0%) underwent gastrectomy with omentectomy. Overall survival after omental preservation was similar compared with omentectomy in the multivariable Cox model (HR 1.00, 95% c.i. 0.83 to 1.20; P = 0.967). Omental preservation also had similar surgical outcomes including lymph node yield and postoperative morbidity rate, compared with omentectomy.</p><p><strong>Conclusions: </strong>Omental preservation was similar to omentectomy in terms of overall survival and surgical outcomes. The results suggest that omentectomy can safely be omitted in curative-intent gastrectomy for gastric cancer.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975804/pdf/","citationCount":"0","resultStr":"{\"title\":\"Omental preservation versus omentectomy in curative-intent gastrectomy for gastric cancer: Swedish population-based cohort study.\",\"authors\":\"Biying Huang, Chih-Han Kung, Andrianos Tsekrekos, Fredrik Klevebro, Raphaela Mayerhofer, Laura Vossen Engblom, Mats Lindblad, Jakob Hedberg, Eva Szabo, David Edholm, Ulrika Smedh, Jan Johansson, Ioannis Rouvelas, Magnus Nilsson\",\"doi\":\"10.1093/bjsopen/zraf012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Omentectomy has traditionally been performed in gastric cancer surgery, but omental preservation has become increasingly common. It is unclear whether omentectomy leads to additional survival benefit compared with omental preservation. This nationwide population-based cohort study aimed to assess survival and surgical outcomes comparing omental preservation to omentectomy in curative-intent gastrectomy.</p><p><strong>Methods: </strong>Patients were identified from the Swedish National Registry for Oesophageal and Gastric Cancer with inclusion between 2006 and 2022. The primary endpoint was overall survival assessed by a multivariable Cox proportional hazards model, adjusted for age, sex, American Society of Anesthesiologists physical status score, clinical T and N stage, type of gastrectomy, surgical approach, extent of lymphadenectomy, neoadjuvant chemotherapy, surgery year and regional cancer centre. Secondary endpoints were surgical outcomes including tumour-free resection margins, lymph node yield and postoperative complications.</p><p><strong>Results: </strong>A total of 1615 patients were included, 517 (32.0%) underwent gastrectomy with omental preservation, and 1098 (68.0%) underwent gastrectomy with omentectomy. Overall survival after omental preservation was similar compared with omentectomy in the multivariable Cox model (HR 1.00, 95% c.i. 0.83 to 1.20; P = 0.967). Omental preservation also had similar surgical outcomes including lymph node yield and postoperative morbidity rate, compared with omentectomy.</p><p><strong>Conclusions: </strong>Omental preservation was similar to omentectomy in terms of overall survival and surgical outcomes. The results suggest that omentectomy can safely be omitted in curative-intent gastrectomy for gastric cancer.</p>\",\"PeriodicalId\":9028,\"journal\":{\"name\":\"BJS Open\",\"volume\":\"9 2\",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-03-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975804/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJS Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/bjsopen/zraf012\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJS Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bjsopen/zraf012","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景:传统上在胃癌手术中采用网膜切除术,但网膜保存已越来越普遍。与网膜保留相比,网膜切除术是否能带来额外的生存益处尚不清楚。这项以全国人群为基础的队列研究旨在评估治疗性胃切除术中网膜保留与网膜切除的生存率和手术结果。方法:从2006年至2022年间纳入的瑞典国家食管癌和胃癌登记处确定患者。主要终点是通过多变量Cox比例风险模型评估总生存率,该模型对年龄、性别、美国麻醉医师协会身体状况评分、临床T和N分期、胃切除术类型、手术入路、淋巴结切除术程度、新辅助化疗、手术年份和地区癌症中心进行了调整。次要终点是手术结果,包括无肿瘤切除边缘、淋巴结生成量和术后并发症。结果:共纳入1615例患者,517例(32.0%)行胃切除术并保留网膜,1098例(68.0%)行胃切除术并网膜切除术。在多变量Cox模型中,网膜保留后的总生存率与网膜切除术后相似(HR 1.00, 95% ci 0.83 ~ 1.20;P = 0.967)。与网膜切除术相比,网膜保存术也有相似的手术结果,包括淋巴结产量和术后发病率。结论:网膜保留在总体生存和手术结果方面与网膜切除术相似。结果提示,在胃癌根治性胃切除术中,网膜切除术是可以安全省略的。
Omental preservation versus omentectomy in curative-intent gastrectomy for gastric cancer: Swedish population-based cohort study.
Background: Omentectomy has traditionally been performed in gastric cancer surgery, but omental preservation has become increasingly common. It is unclear whether omentectomy leads to additional survival benefit compared with omental preservation. This nationwide population-based cohort study aimed to assess survival and surgical outcomes comparing omental preservation to omentectomy in curative-intent gastrectomy.
Methods: Patients were identified from the Swedish National Registry for Oesophageal and Gastric Cancer with inclusion between 2006 and 2022. The primary endpoint was overall survival assessed by a multivariable Cox proportional hazards model, adjusted for age, sex, American Society of Anesthesiologists physical status score, clinical T and N stage, type of gastrectomy, surgical approach, extent of lymphadenectomy, neoadjuvant chemotherapy, surgery year and regional cancer centre. Secondary endpoints were surgical outcomes including tumour-free resection margins, lymph node yield and postoperative complications.
Results: A total of 1615 patients were included, 517 (32.0%) underwent gastrectomy with omental preservation, and 1098 (68.0%) underwent gastrectomy with omentectomy. Overall survival after omental preservation was similar compared with omentectomy in the multivariable Cox model (HR 1.00, 95% c.i. 0.83 to 1.20; P = 0.967). Omental preservation also had similar surgical outcomes including lymph node yield and postoperative morbidity rate, compared with omentectomy.
Conclusions: Omental preservation was similar to omentectomy in terms of overall survival and surgical outcomes. The results suggest that omentectomy can safely be omitted in curative-intent gastrectomy for gastric cancer.