title: Frequency of lymph node metastasis to the splenic hilus and effect of splenectomy in proximal gastric cancer.
abstract: BACKGROUND
  The purpose of this study was to investigate the clinicopathological characteristics and frequency of lymph node metastasis to the splenic hilus in proximal gastric cancer and the effect of splenectomy.
  
  
  METHODS
  Three hundred and forty-nine patients undergoing total gastrectomy for primary proximal gastric cancer were included. Among these patients, lymph node metastasis to the splenic hilus was histologically assessed in 201 cases.
  
  
  RESULTS
  The incidence of lymph node metastasis to the splenic hilus was 31 cases (15.4%). No lymph node metastasis to the splenic hilus was detected in any T1 and T2 tumors located at the lesser curvature and anterior wall. No significant difference was observed between the survival rates of patients with and without splenectomy in each stage.
  
  
  CONCLUSIONS
  Our findings indicated that gastrectomy with spleen preservation may be recommended at least in patients with T1 or T2 tumors located at the lesser curvature and anterior wall.
authors: Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan. sasachy@yahoo.co.jp
authors: Shinsuke
authors: S
authors: Sasada
authors: Motoki
authors: M
authors: Ninomiya
authors: Masahiko
authors: M
authors: Nishizaki
authors: Masao
authors: M
authors: Harano
authors: Yasutomo
authors: Y
authors: Ojima
authors: Hiroyoshi
authors: H
authors: Matsukawa
authors: Hideki
authors: H
authors: Aoki
authors: Shigehiro
authors: S
authors: Shiozaki
authors: Satoshi
authors: S
authors: Ohno
authors: Norohisa
authors: N
authors: Takakura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000556:secondary* / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult