title: The insertion of the lesser and greater gastric omenta and its significance for the T classification of gastric carcinomas (UICC).
abstract: The problem of T classification of proximal gastric carcinomas is becoming increasingly important due to a rise in the incidence of these tumors. The aim of this study was to examine the gastric insertion of the lesser and greater omenta and its role in the T classification of gastric carcinomas. The stomach and greater and lesser omenta were removed from 76 fixed cadavers and 12 measurements each were done in defined localizations. The lesser omentum extended to the gastric wall in 98% of the cases. This junction as well as the omental thickness and thus the retroperitoneal part are especially pronounced in the cardiac region. According to the current UICC classification, even advanced tumors extending into the gastric wall can be classified T2 as long as they do not penetrate the visceral peritoneum. This results in "understaging" and a seemingly poorer prognosis for cardiac carcinomas. Our study results support the recommendation of Hermanek and Wittekind [5] to subdivide the T2 stage of gastric carcinomas on the basis of infiltration depth.
authors.affiliation: Department of Surgery, University Medical Center Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, D-12200 Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kruschewski
authors.forename: N
authors.initials: N
authors.lastname: al-Fakhri
authors.forename: N
authors.initials: N
authors.lastname: Runkel
authors.forename: H J
authors.initials: HJ
authors.lastname: Buhr
mesh_terms: D002102:Cadaver; D002277:Carcinoma / Q000145:classification* / Q000175:diagnosis; D016001:Confidence Intervals; D006801:Humans; D009852:Omentum / Q000033:anatomy & histology*; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000145:classification* / Q000175:diagnosis