Abstract

BACKGROUND/AIMS
Splenectomy is the most common combined organ resection in the surgical management for gastric cardia cancer. The role of combined splenectomy is still controversial.
METHODOLOGY
From January 1998 to December 2006, a total of 174 patients received radical total gastrectomy for advanced adenocarcinoma of cardia. Patients with previous gastric surgery or tumor invasion of pancreas or spleen were excluded. Among them, 115 patients were enrolled in this study. Patients were divided into group 1 (splenectomy, n=47) and group 2 (spleen preservation, n=68). Their clinicopathological characteristics were compared.
RESULTS
Multivariate analysis showed that only tumor size and lymphovascular invasion were two independent indicators of survival. The surgically-related morbidity and mortality rates were similar between the two groups. Among the 3 patients with splenic hilar lymph nodes metastasis, all of them had large tumor size (=4cm), advanced stage (stage III and IV) and tumor center located at the posterior wall of stomach. The 5-year overall survival for advanced cancer was similar (57.1% vs. 60.2%, p=0.681).
CONCLUSIONS
Splenectomy does not improve overall survival in the management of advanced gastric cardia cancer. Splenectomy has limited clinical benefits except for large advanced tumors located at the posterior wall of stomach.

Authors

Fang WL, Huang KH, Wu CW, Chen JH, Lo SS, Hsieh MC, Shen KH, Li AF

Institution

Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.

Source

Hepato-gastroenterology 59:116 2012 Jun pg 1150-4

MeSH

Adult
Aged
Cardia
Female
Gastrectomy
Humans
Lymphatic Metastasis
Male
Middle Aged
Morbidity
Neoplasm Staging
Splenectomy
Stomach Neoplasms

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22580669