Does Preservation Of The Spleen Improves Survival After Radical Surgery For Gastric Cancer?

PurposeCurative resection is the treatment of choice for gastric cancer, but it is unclear whether this operation should include splenectomy, or gastrectomy-alone. We conducted a retrospective study in our hospital in which we compared gastrectomy plus splenectomy with gastrectomy-alone surgery for gastric cancer in terms of long-term survival after surgery.MethodsWe selected 214 patients having undergone the treatment with curative intent between 1980 and 2003,100 in the gastrectomy with splenectomy group and 114 in the gastrectomy-alone group. Every procedure was verified by pathological analyses. The primary endpoints were 5-year overall survival.ResultsMedian follow-up periods were 18 months assigned to gastrectomy with splenectomy group and 26.5 months assigned to gastrectomy-alone group. Overall 5-year survival was significantly higher in patients assigned gastrectomy-alone surgery than in those assigned gastrectomy with splenectomy surgery [33.8%(95% CI,24.2% to 43.4%) vs 28.8%(95% CI,19.6% to 38.0%); log-rank, p=0.013].ConclusionsSplenectomy does not benefit the patient and its routine use in the course of radical resections for gastric cancer should be abandoned.