Prognostic impact of splenectomy on gastric cancer: Results of the Korean Gastric Cancer Study Group

Sung Joon Kwon, Jong In Lee, Dong Wook Choi, Ho Yoon Bang, Moo Song Lee, Byung Sik Kim, Sung Tae Oh, Young Jae Mok, Joe Hyun Park, Doo Hyun Yang, Kyung Kyu Park, Dae Hyun Yang, Young Jin Song, Hyo Young Yun, Byung Joo Park, Byung Kee Kim

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Abstract

The relation between splenectomy and survival time after curative total gastrectomy for gastric cancer was reviewed retrospectively on 492 patients treated at nine hospitals between 1989 and 1993. Altogether 260 patients underwent splenectomy, and 232 patients did not. A univariate analysis revealed that the survival time of patients with splenectomy was significantly less than those without splenectomy (p = 0.0265). In a subgroup of our patients stratified to adjust for the stage of disease, there was no significant difference between the survival rates. Splenectomy remained insignificant according to the multivariate analysis using Cox's proportional-hazard regression. The splenectomy group was associated with more risk factors (e.g., T3/T4 tumors, positive nodes, stage greater than III, large tumor size) that are powerful predictors of death due to gastric cancer. In a separate multivariate analysis after eliminating those who had a T4 tumor invasion or a N2 nodal positivity from the analysis (or both), splenectomy again remained insignificant. In conclusion, we could not find any beneficial effect of splenectomy in gastric cancer patients in this retrospective multivariate analysis. We can presume that splenectomy cannot increase the survival rate so long as the splenectomy group has more risk factors than the nonsplenectomy group, Therefore randomized prospective clinical trials using more precise criteria to indicate the need for splenectomy are needed to assess whether splenectomy is beneficial.

Original languageEnglish
Pages (from-to)837-844
Number of pages8
JournalWorld Journal of Surgery
Volume21
Issue number8
DOIs
Publication statusPublished - 1997 Oct 1
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Kwon, S. J., Lee, J. I., Choi, D. W., Bang, H. Y., Lee, M. S., Kim, B. S., Oh, S. T., Mok, Y. J., Park, J. H., Yang, D. H., Park, K. K., Yang, D. H., Song, Y. J., Yun, H. Y., Park, B. J., & Kim, B. K. (1997). Prognostic impact of splenectomy on gastric cancer: Results of the Korean Gastric Cancer Study Group. World Journal of Surgery, 21(8), 837-844. https://doi.org/10.1007/s002689900314