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J Korean Cancer Assoc > Volume 29(4); 1997 > Article
Journal of the Korean Cancer Association 1997;29(4): 632-639.
Effects of Combined Splenectomy with Total Gastrectomy on the Prognosis in Gastric Cancer
Young Jae Mok, Seung Joo Kim, Gil Soo Son, Min Young Cho, Young Chul Kim, Sae Min Kim
Department of Surgery, Korea University College of Medicine, Seoul, Korea.
ABSTRACT
PURPOSE:
This study was carried out to evaluate the impact of combined splenectomy with total gastrectomy on survival and postoperative morbidity in advanced gastric cancer. PATIENTS AND
METHODS:
We performed a retrospective analysis of 193 patients who underwent curative resection among 289 patients with total gastrectomy during the period of Sep. 1983 through Dec. 1995 at the Department of Surgery, Korea University Hospital.
RESULTS:
Out of 11 clinicopathologic factors, 5 were associated with splenectomy through univariate analysis. The incidence of splenectomy increased when the patients with advanced gastric cancer had Borrmann type III, Gross T3 & T4 stage, greater than 4 cm of tumor size, Serosal invasion, or UICC stage IIIb, IV (p<0.05). Postoperative complication occurred more commonly in splenectomy group than in non-splenectomy group (20.2% vs 16.9%). The 5-year survival rate of Stage II was lower in splenectomy group than in non-splenectomy group (63.5% vs 83.5%) but that of Stage III was higher in splenectomy group than in non-splenectomy group (22.8% vs 17.3%), there was no significant difference between the survival rates across different stages.
CONCLUSION:
We could not find any beneficial effect of splenectomy in gastric cancer patients who underwent curative total gastrectomy in this retrospective analysis. There was no clinical evidence to support splenectomy as a general policy in patients with total gastrectomy. We conclude that the randomized prospective clinical trials using more precise criteria for the indication of splenectomy are needed in order to assess the beneficial effect of splenectomy.
Key words: Gastric cancer;Splenectomy;Prognosis
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