Is concomitant splenectomy beneficial for the long-term survival of patients with gastric cancer undergoing curative gastrectomy? A single-institution study.

BACKGROUND

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.

METHODS

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).

RESULTS

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).

CONCLUSIONS

Splenectomy does not benefit patients undergoing gastrectomy for gastric cancer. Routine splenectomy should be abandoned in patients undergoing radical resections for gastric cancer.