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Meta-Analysis
. 2022 Sep 7;58(9):1241.
doi: 10.3390/medicina58091241.

Gastrectomy with or without Complete Omentectomy for Advanced Gastric Cancer: A Meta-Analysis

Maurizio Zizzo  1 , Magda Zanelli  2 , Francesca Sanguedolce  3 , Andrea Palicelli  2 , Stefano Ascani  4   5 , Andrea Morini  1 , David Tumiati  1 , Federica Mereu  1 , Antonia Lavinia Zuliani  1 , Melissa Nardecchia  1 , Francesca Gatto  1 , Manuel Zanni  1 , Alessandro Giunta  1
Affiliations
Meta-Analysis

Gastrectomy with or without Complete Omentectomy for Advanced Gastric Cancer: A Meta-Analysis

Maurizio Zizzo et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Surgery remains the only possible curative treatment for advanced gastric cancer (AGC). Peritoneal metastases are estimated to occur in approximately 55-60% AGC patients. Greater omentum is the most common metastatic area in AGC. At present, omentectomy alone or bursectomy are usually carried out during gastric cancer surgery. We performed a meta-analysis in order to evaluate long-term and short-term outcomes among AGC patients, who have undergone radical gastrectomy with or without complete omentectomy (CO). Materials and Methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Meta-analysis was performed by use of RevMan (Computer program) Version 5.4. Results: The eight included studies covered an approximately 20 years long study period (2000-2018). Almost all included studies were retrospective ones and originated from Asian countries. Meta-analysis indicated gastrectomy without CO as significantly associated with longer 3-year (RR: 0.94, 95% CI: 0.90-0.98, p = 0.005) and 5-year overall survivals (OS) (RR: 0.93, 95% CI: 0.88-0.98, p = 0.007). Moreover, we found longer operative time (MD: 24.00, 95% CI: -0.45-48.45, p = 0.05) and higher estimated blood loss (MD: 194.76, 95% CI: 96.40-293.13, p = 0.0001) in CO group. Conclusions: Non-complete omentectomy (NCO) group had a statistically greater rate in 3-year and 5-year OSs than the CO group, while the CO group had significantly longer operative time and higher estimated blood loss than the NCO group. Further randomized, possibly multi-center trials may turn out of paramount importance in confirming our results.

Keywords: gastrectomy; gastric cancer; omentectomy; omentum; outcomes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart of literature search.
Figure 2
Figure 2
Forest plot comparing 3-year OS between the CO and NCO groups. CI, confidence interval; M–H, Mantel–Haenszel [16,17,18,19,20,21].
Figure 3
Figure 3
Forest plot comparing 5-year OS between the CO and NCO groups. CI, confidence interval; M–H, Mantel–Haenszel [16,17,18,19,20,21].
Figure 4
Figure 4
Forest plot comparing operative time between the CO and NCO groups. CI, confidence interval; M–H, Mantel–Haenszel [16,18,19,21,27,30].
Figure 5
Figure 5
Forest plot comparing estimated blood loss between the CO and NCO groups. CI, confidence interval; M–H, Mantel–Haenszel [16,19,21,27,30].
See this image and copyright information in PMC

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