Minoru Fukuchi1,2, Erito Mochiki3, Toru Ishiguro3, Kana Saito2, Hiroshi Naitoh2, Youichi Kumagai3, Keiichiro Ishibashi3, Hideyuki Ishida3. 1. Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan mfukuchi@saitama-med.ac.jp. 2. Department of Surgery, Japan Community Health Care Organization, Gunma Chuo Hospital, Gunma, Japan. 3. Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Abstract
BACKGROUND/AIM: We evaluated the survival benefit of splenectomy in patients with esophagogastric junction (ECJ) carcinoma. PATIENTS AND METHODS: We retrospectively examined clinicopathological and survival data for 60 surgically-treated patients with ECJ carcinoma. RESULTS: The 5-year overall survival (OS) rate was 47%. Splenectomy was performed in 20 patients (30%). Multivariate Cox regression analysis revealed splenectomy (odds ratio (OR), 2.70; 95% confidence interval (CI)=1.06-7.17; p=0.04) and venous invasion (OR=3.03; 95%CI=1.20-9.27; p=0.02) as significant independent predictors of poorer OS. Splenic hilar lymph node metastasis was not observed. Multivariate logistic regression analysis identified perioperative blood transfusion (BTF) as a significant independent factor associated with splenectomy. CONCLUSION: The survival benefit of splenectomy in ECJ carcinoma patients may decrease with increasing frequency of perioperative BTF for blood loss. We recommend that splenectomy should be performed carefully when indicated by the extent or invasion of EGJ carcinoma. Copyright
BACKGROUND/AIM: We evaluated the survival benefit of splenectomy in patients with esophagogastric junction (ECJ) carcinoma. PATIENTS AND METHODS: We retrospectively examined clinicopathological and survival data for 60 surgically-treated patients with ECJ carcinoma. RESULTS: The 5-year overall survival (OS) rate was 47%. Splenectomy was performed in 20 patients (30%). Multivariate Cox regression analysis revealed splenectomy (odds ratio (OR), 2.70; 95% confidence interval (CI)=1.06-7.17; p=0.04) and venous invasion (OR=3.03; 95%CI=1.20-9.27; p=0.02) as significant independent predictors of poorer OS. Splenic hilar lymph node metastasis was not observed. Multivariate logistic regression analysis identified perioperative blood transfusion (BTF) as a significant independent factor associated with splenectomy. CONCLUSION: The survival benefit of splenectomy in ECJ carcinomapatients may decrease with increasing frequency of perioperative BTF for blood loss. We recommend that splenectomy should be performed carefully when indicated by the extent or invasion of EGJ carcinoma. Copyright
Authors: B B Pultrum; J van Bastelaar; L M A Schreurs; H M van Dullemen; H Groen; M W N Nijsten; G M van Dam; J T H M Plukker Journal: Dis Esophagus Date: 2008 Impact factor: 3.429