Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer

@article{Yu2006RandomizedCT,
  title={Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer},
  author={W. Yu and G.-S. Choi and H. Y. Chung},
  journal={British Journal of Surgery},
  year={2006},
  volume={93}
}
Preservation or removal of the spleen during total gastrectomy for proximal gastric cancer is a matter of debate. 
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Modified radical lymphadenectomy without splenectomy in patients with proximal gastric cancer: Comparison with standard D2 lymphadenectomy for distal gastric cancer
TLDR
This work assessed the optimal extent of lymph node dissection and the effect of splenectomy in patients with proximal gastric cancer and found that the former is more beneficial than the latter.
Is concomitant splenectomy necessary in radical gastric cancer surgery? A systematic review and meta‐analysis
This study is a systematic review and meta‐analysis compare the short‐ and long‐term outcomes of splenectomy (SP) versus splenic preservation (NSP) in radical gastric cancer surgery.
Significance of Splenectomy for Upper Gastric Carcinoma With Invasion to the Greater Curvature
TLDR
This study aimed to clarify the significance of splenectomy for upper gastric carcinoma with invasion to the greater curvature by conducting a phase III study at the Japan Clinical Oncology Group.
Impact of anastomotic leakage on long‐term survival after total gastrectomy for carcinoma of the stomach
TLDR
It is suggested that anastomotic leak may adversely affect long‐term survival in patients undergoing surgery for gastrointestinal malignancies and total gastrectomy for gastric cancer.
Randomized clinical trials in gastric cancer.
[Gastrectomy with spleen preservation in patients with stomach cancer].
TLDR
It was revealed that splenectomy is not an independent prognostic factor influencing on prolonged survival of patients with stomach cancer and preservation of spleen permits to reduce the number of early postoperative complications.
Surgical considerations in the treatment of gastric cancer.
Splenic hilar lymph node metastasis independently predicts poor survival for patients with gastric cancers in the upper and/or the middle third of the stomach
TLDR
The aim of the present study is to elucidate the impact of splenectomy on patient survival by investigating the pathological characteristics and prognostic significance of splenic hilar lymph node metastasis.
An Evidence-Based Review of the Surgical Treatment of Gastric Adenocarcinoma
TLDR
This review provides an update on the current literature regarding the preoperative evaluation and staging, extent of gastric resection, degree of lymph node resection and adjuvant therapy for patients with gastric adenocarcinoma.
Gastric adenocarcinoma surgery and adjuvant therapy.
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References

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Splenectomy in proximal gastric cancer: Frequency of lymph node metastasis to the splenic hilus
TLDR
The purpose of this study was to investigate the frequency of lymph node metastasis to the splenic hilus and metastases to the spleen in proximal gastric carcinomas.
Prognostic significance of combined splenectomy or pancreaticosplenectomy in total and proximal gastrectomy for gastric cancer.
Complications of splenectomy. Etiology, prevention, and management.
Role of splenectomy in gastric cancer surgery: adverse effect of elective splenectomy on longterm survival.
Surgical treatment of gastric cancer: retrospective survey of 1,704 operated cases with special reference to total gastrectomy as the operation of choice.
TLDR
A precise analysis of the authors' cases in regard to tumor site and tumor type could show a frequency of only 6% to maximally 30%, in which elective total gastrectomy may represent a procedure too extensive to justify for an oncological course.
Prognostic Impact of Splenectomy on Gastric Cancer: Results of the Korean Gastric Cancer Study Group
  • S. Kwon
  • Medicine
    World Journal of Surgery
  • 1997
TLDR
It is presumed that splenectomy cannot increase the survival rate so long as the splen surgery group has more risk factors than the nonsplenectomy group, and randomized prospective clinical trials using more precise criteria are needed to assess whetherSplenectomy is beneficial.
Effect of splenectomy on morbidity and survival following curative gastrectomy for carcinoma.
TLDR
It is concluded that splenectomy has no direct influence on survival, but that it increases the morbidity of curative gastrectomy and should be avoided unless the spleen is close to or invaded by the tumor.
Splenectomy for treatment of gastric cancer: Japanese experience
Surgery for gastric cancer in Japan has frequently been combined with resection of the spleen (splenectomy) or of the pancreatic body and tail and spleen (pancreatosplenectomy, PS). Splenectomy in…
Splenectomy does not correlate with length of survival in patients undergoing curative total gastrectomy for gastric carcinoma. Univariate and multivariate analyses
TLDR
Multivariate analysis using the Cox regression analysis adjusted for sex, age, and other covariates indicated that serosa invasion, lymph node metastasis, and tumor size were the most important prognostic factors, and there was no correlation whatever with splenectomy.
A prospective randomized study comparing D2 total gastrectomy versus D2 total gastrectomy plus splenectomy in 187 patients with gastric carcinoma.
TLDR
On the basis of the results of the present prospective randomized trial, splenectomy is not necessary in early stages of disease and a low operative mortality rate (less than 3%) must be achieved to obtain good long-term results.
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