Significance of a Splenectomy with a Curative Total Gastrectomy for Gastric Cancer A trospective analysis of 237 cases.
- Author:
Jae Bok LEE
1
;
Young Jae MOK
Author Information
1. Department of Surgery, College of Medicine, Korea University.
- Publication Type:Original Article
- Keywords:
Gastric cancer;
Splenectomy;
Prognosis
- MeSH:
Gastrectomy*;
Humans;
Lymph Node Excision;
Postoperative Complications;
Prognosis;
Retrospective Studies;
Spleen;
Splenectomy*;
Stomach Neoplasms*;
Survival Rate
- From:Journal of the Korean Surgical Society
1998;55(1):70-75
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUNDS: A splenectomy is often performed simultaneously with a total gastrectomy for lymph node dissection in gastric cancer. The therapeutic value of a splenectomy in a curative total gastrectomy is controversial. The purpose of this retrospective study is to evaluate the impact of a splenectomy combined with a total gastrectomy on the survival and the postoperative morbidity in gastric cancer. METHODS: From among 343 patients with total gastrectomy for gastric cancer between September 1983 and December 1996, we analyzed 237 patients who underwent a curative resection : 107 patients with a splenectomy and 130 patients without a splenectomy. RESULTS: There were significant differences between the patients with and without a splenectomy with regard to type of cancer, tumor size, and depth of invasion. In those who underwent a splenectomy, the tumor was larger, Borrman type III lesions were more frequent, the depth of invasion was greater, and an advanced stage was more frequent. The 5-year survival rate of the patients with a splenectomy was insignificantly less than that of those without splenectomy (50.6% vs. 57.7%, P> 0.05). There was no significant difference in the survival time according to the stage. Postoperative complications occurred more commonly in the patients of a splenectomy than those without a splenectomy (22.4% vs. 14.6%). CONCLUSIONS: We conclude that a splenectomy did not affect the prognosis for patients with gastric cancer and that efforts should be made to preserve the spleen during a gastrectomy. A prospective study should be done to better define the relationship between a splenectomy and the survival time of patients with gastric cancer.
