title: [Analysis of long-term results of radical gastrectomy combining splenectomy for gastric cancer].
abstract: OBJECTIVE
  To analyze the influence of radical excision combining splenectomy on prognosis of the patients with gastric cancer.
  
  
  METHODS
  Between June 1994 and March 2004, 692 patients were operated on for gastric cancer and registered into gastric cancer database. Radical excision (D2, D3 or D4) combining splenectomy for gastric cancer was performed in 45 cases. 343 cases were selected simultaneously for comparison according to the resembling rules in sex, age, tumor size, location, serosa invasion, Borrmann type and range of lymph node dissection. Clinicopathological factors affecting lymph node metastasis, patterns of lymph node metastasis, 5-year survival rate after radical excision combined with splenectomy for gastric cancer were compared.
  
  
  RESULTS
  Lymph node metastasis rate of splenic hilus was 15.6 percent. Among them, upper, middle and lower domain is 11.5 percent, 33.3 percent and zero respectively. It was significantly different between gastric adenocarcinoma in proximal and body of stomach and that in distal stomach, poor differentiation and adenocarcinoma anaplastic and well and moderately differentiation adenocarcinoma, Borrmann III and IV types and Borrmann I and II types, infiltrated depth in T(3) and T(4) and infiltrated depth in T(1) and T(2), clinical stages III and IV and clinical stages I and II. The average and median survival time between radical gastrectomy only and radical gastrectomy combining splenectomy for gastric cancer at stage I and II patients were significantly different, but at stage III and IV patients not significantly different.
  
  
  CONCLUSIONS
  Spleen should be reserved for patients with gastric cancer at stage I and II, and radical excision combining splenectomy could only be performed at stage III and IV patients with cancer infiltrating body and tail of the pancreas, or lymph nodes metastasis in the splenic hilus. Indication of radical excision combining splenectomy for gastric cancer must be further study to clarify its efficacy.
authors.affiliation: Department of Gastrointestinal and Pancreatic Surgery of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Fang-hai
authors.initials: FH
authors.lastname: Han
authors.forename: Wen-hua
authors.initials: WH
authors.lastname: Zhan
authors.forename: Yu-ming
authors.initials: YM
authors.lastname: Li
authors.forename: Yu-long
authors.initials: YL
authors.lastname: He
authors.forename: Jun-sheng
authors.initials: JS
authors.lastname: Peng
authors.forename: Jin-ping
authors.initials: JP
authors.lastname: Ma
authors.forename: Zhao
authors.initials: Z
authors.lastname: Wang
authors.forename: Zheng-xuan
authors.initials: ZX
authors.lastname: Chen
authors.forename: Zhang-qing
authors.initials: ZQ
authors.lastname: Zheng
authors.forename: Jian-ping
authors.initials: JP
authors.lastname: Wang
authors.forename: Yi-hua
authors.initials: YH
authors.lastname: Huang
authors.forename: Wen-guang
authors.initials: WG
authors.lastname: Dong
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate