Frank Wang1, Yu-Cheng Chang2, Tsung-Hsing Chen3, Jun-Te Hsu4, Chia-Jung Kuo5, Chun-Jung Lin6, Jen-Shi Chen7, Kun-Chun Chiang8, Ta-Sen Yeh9, Tsann-Long Hwang10, Yi-Yin Jan11. 1. Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: fwang1881@gmail.com. 2. Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: cusszard@gmail.com. 3. Department of Gastroenterology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: itochenyu@gmail.com.tw. 4. Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: hsujt2813@adm.cgmh.org.tw. 5. Department of Gastroenterology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: m7011@cgmh.org.tw. 6. Department of Gastroenterology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: m1249@cgmh.org.tw. 7. Department of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: js1101@adm.cgmh.org.tw. 8. Department of Surgery, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: robertviolet6292@yahoo.com.tw. 9. Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: tsy471027@adm.cgmh.org.tw. 10. Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: hwangtl@adm.cgmh.org.tw. 11. Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, ROC. Electronic address: janyy@adm.cgmh.org.tw.
Abstract
BACKGROUND: The addition of splenectomy to a D2 gastrectomy in patients with gastric adenocarcinoma (GA) has remained controversial. This study aimed to assess the impact of splenectomy on the overall survival of patients undergoing total gastrectomy for GA. METHODS: This was a retrospective review of 463 GA patients (excluding positive resection margins and pathologic spleen invasion) undergoing curative total gastrectomy with (TS) and without splenectomy (T) between 1994 and 2008. Clinicopathologic factors affecting the prognosis of these patients were collected prospectively and analyzed. RESULTS: Two hundred and ninety one patients had T and 172 patients underwent TS. Patient clinicopathological characteristics were comparable between the 2 groups except for tumor size. There were no significant differences in postoperative morbidity and mortality between T and TS groups. Patients in the T group had similar 3- and 5-year survival rates compared with those in the TS groups (p = 0.181). The addition of splenectomy to a total gastrectomy did not impact on the overall survival rates in patients with GA in terms of depth of tumor invasion and nodal metastasis. CONCLUSIONS: The addition of splenectomy is not associated with survival advantage in GA patients undergoing total gastrectomy.
BACKGROUND: The addition of splenectomy to a D2 gastrectomy in patients with gastric adenocarcinoma (GA) has remained controversial. This study aimed to assess the impact of splenectomy on the overall survival of patients undergoing total gastrectomy for GA. METHODS: This was a retrospective review of 463 GA patients (excluding positive resection margins and pathologic spleen invasion) undergoing curative total gastrectomy with (TS) and without splenectomy (T) between 1994 and 2008. Clinicopathologic factors affecting the prognosis of these patients were collected prospectively and analyzed. RESULTS: Two hundred and ninety one patients had T and 172 patients underwent TS. Patient clinicopathological characteristics were comparable between the 2 groups except for tumor size. There were no significant differences in postoperative morbidity and mortality between T and TS groups. Patients in the T group had similar 3- and 5-year survival rates compared with those in the TS groups (p = 0.181). The addition of splenectomy to a total gastrectomy did not impact on the overall survival rates in patients with GA in terms of depth of tumor invasion and nodal metastasis. CONCLUSIONS: The addition of splenectomy is not associated with survival advantage in GA patients undergoing total gastrectomy.
Authors: Serkan Karaisli; Emine Ozlem Gur; Oguzhan Ozsay; Fevzi Cengiz; Ahmet Er; Murat Kemal Atahan; Yasin Peker; Osman Nuri Dilek; Mehmet Haciyanli Journal: Sisli Etfal Hastan Tip Bul Date: 2021-03-17