World J Surg Oncol. 2014 Jun 26;12:193. doi: 10.1186/1477-7819-12-193.
Curative resection is the treatment of choice for gastric cancer, but it is unclear whether gastrectomy should also include splenectomy. We retrospectively analyzed long-term survival in patients in our hospital who underwent gastrectomy plus splenectomy (G+S) or gastrectomy alone (G-A) for gastric cancer.
We identified 214 patients who underwent surgery with curative intent between 1980 and 2003. Of these, 100 underwent G+S, and 114 underwent G-A. The primary endpoint was 5-year overall survival (OS).
Median follow-up was 18 months in patients who underwent G+S, and 26.5 months in patients who underwent G-A. The 5-year OS rate was significantly higher in patients who underwent G-A (33.8%; 95% CI 24.2 to 43.4%) than in those who underwent G+S (28.8%; 95% CI 19.6 to 38.0%) (log-rank test, P=0.013).
Splenectomy does not benefit patients undergoing gastrectomy for gastric cancer. Routine splenectomy should be abandoned in patients undergoing radical resections for gastric cancer.
根治性切除术是胃癌的治疗选择，但胃切除术是否也应包括脾切除术尚不清楚。我们回顾性分析了我院接受胃癌胃切除术加脾切除术（G+S）或单纯胃切除术（G-A）治疗的患者的长期生存情况。
我们确定了 1980 年至 2003 年间接受根治性手术的 214 名患者。其中 100 例接受 G+S，114 例接受 G-A。主要终点是 5 年总生存率（OS）。
接受 G+S 的患者中位随访时间为 18 个月，接受 G-A 的患者为 26.5 个月。接受 G-A 的患者 5 年 OS 率明显高于接受 G+S 的患者（33.8%；95%CI24.2%至 43.4%）（对数秩检验，P=0.013）。
脾切除术对接受胃癌胃切除术的患者无益。在接受胃癌根治性切除术的患者中，常规脾切除术应被摒弃。
