Preliminary exploration of greater omentum metastasis rate in patients with gastric cancer: clinical pilot study of Dragon 05 trial

doi:10.16139/j.1007-9610.2025.01.08

Abstract

Abstract:

Objective To investigate the rate of greater omentum metastasis in gastric cancer(GC). Methods General informations of patients with GC who underwent radical gastrectomy at Shanghai Ruijin Hospital in May 2020 were collected, and their clinicopathological characteristics were analyzed to find risk factors of greater omentum metastasis. Recurrence and survival were also assessed. Results A total of 59 patients with GC were included in the study, of which 2(3.4%) had greater omentum metastasis. One patient presented a pathological stage of pT4aN3bM0 and another ypT4bN1M0. The 3-year overall survival rate of patients in the study was 87.9%. Conclusions The rate of greater omentum metastasis was relatively low, and patients with greater omentum metastasis had an more advanced pathological stage. To further validate this clinical issue, a prospective randomized controlled clinical study should be conducted between radical gastrectomy with omentectomy and omentum-preserving radical gastrectomy.

Key words: Gastric cancer, Greater omentum, Surgery

CLC Number:

R735.2

HUA Zichen, MEI Yu, LI Chen, YAN Chao, YAN Min, ZHU Zhenggang, YAO Xuexin. Preliminary exploration of greater omentum metastasis rate in patients with gastric cancer: clinical pilot study of Dragon 05 trial[J]. Journal of Surgery Concepts & Practice, 2025, 30(01): 41-46.

Figures/Tables 2

Fig 1

Tab 1

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Variables	Number（%）
Age（years）
Median（interquartile ranges）	63（33，86）
Gender
Male	41（69.5%）
Female	18（30.5%）
cT stage
T1-3	29（49.2%）
T4	30（50.8%）
cN stage
N0	34（57.6%）
N+	25（42.4%）
Tumor location
Cardia/fundus	5（8.5%）
Body	18（30.5%）
Pylorus/antrum	35（59.3%）
Linitis plastica	1（1.7%）
Tumor size（cm）
Median（interquartile ranges）	3（0.5，9）
Neoadjuvant therapy
Yes	8（13.6%）
No	51（86.4%）
Surgical access
Open	53（89.8%）
Laparoscopy	6（10.2%）
Type of gastrectomy
Distal	40（67.8%）
Total	19（32.2%）
Adjuvant chemotherapy
Yes	47（79.7%）
No	12（20.3%）
Histopathology type
Tubular adenocarcinoma	38（64.4%）
Signet ring cell carcinoma	5（8.5%）
Mixed adenocarcinoma	16（27.1%）
Differentiation degree
Differentiated	18（30.5%）
Undifferentiated	41（69.5%）
Greater omentum metastasis
Yes	2（3.4%）
No	57（96.6%）
Perineural invasion
Yes	28（47.5%）
No	31（52.5%）
Lymphovascular invasion
Yes	18（30.5%）
No	41（69.5%）
Pathological stage
Ⅰ	19（32.2%）
Ⅱ	15（25.4%）
Ⅲ	25（42.4%）
Tumor regression grade
0	0
1	1（12.5%）
2	7（87.5%）
3	0