OBJECTIVETo evaluated the prognostic impact of splenectomy on patients with advanced proximal gastric cancer.

METHODSThe clinical records of 237 patients with advanced proximal gastric cancer who underwent D2 curative resection combined with splenectomy from January 1980 to June 2003 were analyzed retrospectively. Seventy-five patients presented with No.10 lymph nodes metastasis, while 162 patients did not. Potential patient prognostic factors were evaluated by univariate and multivariate analysis. The independent prognostic factors of patients were performed subgroup analysis.

RESULTSThe 5-year survival rate was 27.7% for patients with No.10 lymph nodes metastasis and 35.4% for patients without, the difference was statistically significant between the two groups (P < 0.05). On univariate analysis, lymph node metastasis, macroscopic appearance, depth of invasion, type of gastrectomy and No.10 lymph nodes metastasis were predictive factors of survival. The depth of invasion, type of gastrectomy and No.10 lymph nodes metastasis were independent prognostic factors. In the subgroup analysis, the survival rates of T3 patients with and without No.10 lymph nodes metastasis was 34.5% and 39.7%, respectively (P > 0.05). For patients undergoing total gastrectomy, survival rates were 31.2% and 36.7%, respectively (P > 0.05).

CONCLUSIONSTo improve patient prognosis, total gastrectomy with splenectomy should be recommended for patients with T3 proximal gastric cancer with No.10 lymph node metastasis.