Is there a benefit of pancreaticosplenectomy with gastrectomy for advanced gastric cancer?
BACKGROUND
In Japan, wide resection with extended lymph node dissection has been performed for advanced cancer with good prognosis. Pancreaticosplenectomy with gastrectomy is performed to facilitate dissection of the lymph nodes around the splenic artery. We attempted to evaluate the effects of pancreaticosplenectomy and splenectomy with gastrectomy for advanced gastric cancer.


METHODS
Gastric cancer patients underwent splenectomy with gastrectomy (78 cases), pancreaticosplenectomy with gastrectomy (105 cases), or gastrectomy alone (1,755 cases). Survival rates were compared among the three groups for each factor of the depth of invasion, stage, and curability.


RESULTS
There were no significant differences among the three groups. Pancreaticosplenectomy or splenectomy with gastrectomy to dissect lymph nodes does not improve survival but is associated with severe complications.


CONCLUSIONS
The spleen should be resected when a patient has clearly positive node metastasis around the splenic hilus and artery, and pancreaticosplenectomy be performed when the cancer lesion invades the pancreas.
Kasakura
Y
Y
Third Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
Fujii
M
M
Mochizuki
F
F
Kochi
M
M
Kaiga
T
T
D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D007564:Japan; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000009:adverse effects; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects; D013157:Splenic Artery / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate