Systemic Review and Meta-analysis of Impact of Splenectomy for Advanced Gastric Cancer

Kunisaki, Chikara; Sato, Shigeo; Tsuchiya, Nobuhiro; Watanabe, Jun; Sato, Tsutomu; Takeda, Kazuhisa; Kasahara, Keiji; Kubo, Takashi; Akiyama, Hirotoshi; Endo, Itaru; Misumi, Toshihiro

doi:10.21873/invivo.12145

Cited by 5 publications

(3 citation statements)

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“…Our study found gastric cancer patients in splenectomy group showed a signi cantly higher hospital mortality than no splenectomy group because our research including more studies. Regarding to postoperative complication, most meta-analysis demonstrated that gastrectomy with splenectomy had signi cantly higher incidence of postoperative complications, which was consistent with our results [13,14,119,123,124]. Previous meta-analysis found that the incidence rate of postoperative complications, including PSVT and pancreatic injury, was signi cantly higher in the splenectomy group [15].…”

Section: Discussionsupporting

confidence: 90%

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Spleen plays a two-way role in cancer incidence and cancer progression

Yang

Liu

et al. 2022

Preprint

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Background:The link between splenectomy and cancer outcomes remains unclear. Our aim was to investigate the association between splenectomy and cancer incidence, cancer progression in cancer patients. Methods:Pooled estimates of the relative risks (RR) for cancer incidence and cancer progression were performed in a meta-analysis by random effects or ﬁxed effects models as appropriate. Results:Eighty-one literatures were included in our meta-analysis. We found some interesting results. First, splenectomy was associated with a signiﬁcantly increased risk of overall cancer, Non Hodgkin lymphoma, Hodgkin lymphoma, lung cancer, leukemia, breast cancer, oral and pharyngeal cancer, skin cancer, esophagus cancer, prostate cancer, bladder cancer, gastric cancer, pancreas cancer, brain and nervous system cancer. Interestingly, splenectomy for trauma increased the risk of liver cancer while splenectomy for protal hypertension decreased the risk of liver cancer. Second, splenectomy was associated with a signiﬁcantly lower 5-year overall survival (OS) for gastric cancer, colorectal cancer, esophageal and esophago‑gastric junction cancer while splenectomy was associated with a signiﬁcantly higher 5-year OS for liver cancer. Subgroup analyses based on tumor stage showed that splenectomy for gastric cancer was associated with a signiﬁcantly lower 5-year OS only for stage Ⅱ and stage Ⅲ but stage Ⅰand stage Ⅳ. Third, splenectomy increased the rate of hospital mortality of gastric cancer but had no effects on the hospital mortality of liver cancer, esophageal and esophago‑gastric junction cancer. Finally, splenectomy increased the incidence of some specific postoperative complications for cancer patients. Conclusions:Splenectomy was associated with cancer incidence, cancer survival, hospital mortality, and postoperative complications. Spleen plays a two-way role in cancer incidence and cancer progression.

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Section: Discussionsupporting

confidence: 90%

“…Previous meta-analysis found splenectomy did not increase the mortality of gastric cancer and liver cancer [13,14,16,[119][120][121][122][123][124]. Similarly, our study found there were no signi cant differences in hospital mortality for liver cancer and esophageal and esophago-gastric junction cancer between two groups.…”

Section: Discussionsupporting

confidence: 74%

Spleen plays a two-way role in cancer incidence and cancer progression

Yang

Liu

et al. 2022

Preprint

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show abstract

“…2 cm: endoskopische Resektion >G1 / > 2cm: Gastrektomie + D2-LAD G1, ≤ 1,5 cm: endoskopische Resektion >G1 / > 1,5cm: Gastrektomie + D2-LAD Gastrektomie + D2-LAD Gastrektomie + Systemtherapie, BSC, Gastrektomie +/-Metastasektomie nur als Individualentscheidung Splenektomie oder Pankreaslinksresektion, die in der Studie häufig im Rahmen der D2-LAD durchgeführt wurden, vergesellschaftet. Weitere Studien konnten zeigen, dass eine D2-LAD ohne Pankreaslinksresektion und Splenektomie bei entsprechender chirurgischer Erfahrung die postoperative Mortalität nicht erhöht, sodass empfohlen wird, diese Eingriffserweiterungen nur bei zwingender technischer Notwendigkeit durchzuführen[3,14,15,16].…”

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