title: Efficacy of splenectomy for hypersplenic patients with advanced hepatocellular carcinoma.
abstract: OBJECTIVE
  Chemotherapy for advanced hepatocellular carcinoma (HCC) patients with hypersplenism is generally unsatisfactory, as a lower-dose therapy is usually administered. Splenectomy may represent a better approach to overcoming the complication due to hypersplenism in patients with advanced HCC. This retrospective study was conducted to evaluate whether HCC patients who undergo splenectomy show improved prognosis.
  
  
  METHODS
  We examined 34 HCC patients. Twenty-two had thrombocytopenia and/or leucopenia and underwent laparoscopic splenectomy. The completion rate of full-dose drug regimens, the response rate, the toxicity of chemotherapy and the cumulative survival rate were compared between the splenectomy and non-splenectomy groups.
  
  
  RESULTS
  The response rate and the cumulative survival rate in the splenectomy group were significantly better than that in the non-splenectomy group.
  
  
  CONCLUSIONS
  Splenectomy is an efficient method for advanced HCC patients with hypersplenism treated by chemotherapy.
authors.affiliation: Department of Gastroenterology and Metabology, Graduate School of Medicine, Ehime University, Onsen, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Ishida
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Kisaka
authors.forename: Takahide
authors.initials: T
authors.lastname: Uehara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Kojiro
authors.initials: K
authors.lastname: Michitaka
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji