Prognostic significance of combined splenectomy or pancreaticosplenectomy in total and proximal gastrectomy for gastric cancer.

The prognostic significance of combined splenectomy or pancreaticosplenectomy in total and proximal gastrectomy for gastric cancer was evaluated from the viewpoints of lymph node metastasis in the splenopancreatic region and postoperative long-term survival. The postoperative long-term results were not improved in patients who had undergone combined resection, indicating that the course after total or proximal gastrectomy for advanced gastric cancer is more affected by serosal invasion than lymph node metastasis in the splenopancreatic region. Therefore, combined resection may be of prognostic significance in patients with gastric cancer manifesting lymph node metastasis in the splenopancreatic region but not serosal invasion.