Prognostic significance of splenectomy for patients with gastric adenocarcinoma undergoing total gastrectomy : a retrospective cohort study

Background: The addition of splenectomy to a D2 gastrectomy in patients with gastric adenocarcinoma (GA) has remained controversial. This study aimed to assess the impact of splenectomy on the overall survival of patients undergoing total gastrectomy for GA. Methods: This was a retrospective review of 463 GA patients (excluding positive resection margins and pathologic spleen invasion) undergoing curative total gastrectomy with (TS) and without splenectomy (T) between 1994 and 2008. Clinicopathologic factors affecting the prognosis of these patients were collected prospectively and analyzed. Results: Two hundred and ninety one patients had T and 172 patients underwent TS. Patient clinicopathological characteristics were comparable between the 2 groups except for tumor size. There were no significant differences in postoperative morbidity and mortality between T and TS groups. Patients in the T group had similar 3- and 5-year survival rates compared with those in the TS groups (p=0.181). The addition of splenectomy to a total gastrectomy did not impact on the overall survival rates in patients with GA in terms of depth of tumor invasion and nodal metastasis. Conclusions: The addition of splenectomy is not associated with survival advantage in GA patients undergoing total gastrectomy.