COMPLETE OMENTECTOMY AND EXTENSIVE LYMPHADENECTOMY WITH GASTRECTOMY IMPROVES THE SURVIVAL OF GASTRIC-CANCER PATIENTS WITH METASTASES IN THEADJACENT PERITONEUM

BACKGROUND/AIMS: The omentum is the site where peritoneal metastases o ccur most frequently. It has pot been shown whether complete resection of the omenta during gastrectomy improves the survival of gastric can cer patients with macroscopic peritoneal metastases. METHODOLOGY: We r etrospectively analyzed 126 patients who underwent gastrectomies for g astric cancer with peritoneal metastases but without hematogenous meta stases. The 126 patients were stratified according to their grade of p eritoneal metastases into three groups: the P1 patients (patients with peritoneal metastases in the adjacent peritoneum but not in the dista nt peritoneum); the P2 patients (patients with a few peritoneal metast ases in the distant peritoneum); and the P3 patients (patients with ma ny metastases in the distant peritoneum). In each group, the survival and clinicopathological characteristics were compared between patients treated by complete resection of the greater omentum and the lesser o mentum plus extensive lymphadenectomy during gastrectomy, versus patie nts treated by incomplete resection of the omenta and non-extensive ly mphadenectomy during gastrectomy. RESULTS: Complete omentectomy and ex tensive lymphadenectomy during gastrectomy improved survival significa ntly only in the P1 patients. Other clinicopathological characteristic s did not differ between them. CONCLUSION: Complete omentectomy and ex tensive lymphadenectomy is recommended in patients with peritoneal met astases in the adjacent peritoneum but not in the distant peritoneum.