Prognostic impact of prophylactic splenectomy for upper-third gastric cancer: a cohort study.

Abstract

AIM: The aim of this study was to investigate the effect of splenectomy on survival outcomes and recurrence in patients who underwent curative surgery for gastric cancer. PATIENTS AND METHODS: This is a retrospective study of 129 patients who underwent upper-third gastric cancer curative resection with lymphadenectomy. Forty-two patients (32%) also underwent splenectomy. RESULTS: The median follow-up period was 33 months. Approximately 40% of the patients had lymph node metastases; four of them had nodal involvement along the splenic artery and 5 had nodal involvement at the splenic hilum. No patients in the pT1-2 group with nodal metastases had involvement of the splenic hilar lymph nodes. There was no significant association between splenectomy and either overall or disease-free survival in the patients. CONCLUSION: Splenectomy should not be performed in patients with pT1-2 tumors for prophylactic lymphadenectomy.