Splenectomy does not correlate with length of survival in patients undergoing curative total gastrectomy for gastric carcinoma. Univariate and multivariate analyses.

The relationship between splenectomy and survival time after curative total gastrectomy for advanced gastric cancer was examined by reviewing retrospectively data on 252 patients treated in our clinics between 1965 and 1985. One hundred three patients (40.9%) did not undergo splenectomy and 149 (59.1%) did. In patients subjected to splenectomy, advanced stages of the malignancy were more frequent and metastasis was noticed in 8.1% of splenic hilar lymph nodes and in 10.1% of the lymph nodes associated with the splenic artery. A univariate analysis revealed that the survival time of patients with splenectomy was significantly less than those for whom splenectomy was not done (P less than 0.05). In a subgroup of our patients stratified to adjust for the stage of disease, there was no significant difference between the survival rates. Subsequently, multivariate analysis using the Cox regression analysis adjusted for sex, age, and other covariates indicated that serosa invasion, lymph node metastasis, and tumor size were the most important prognostic factors, and there was no correlation whatever with splenectomy. Our findings rule out any relationship between splenectomy and length of survival time in patients undergoing curative total gastrectomy for advanced gastric cancer.