Frequency of lymph node metastasis to the splenic hilus and effect of splenectomy in proximal gastric cancer.
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.
Sasada
Shinsuke
S
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
Ninomiya
Motoki
M
Nishizaki
Masahiko
M
Harano
Masao
M
Ojima
Yasutomo
Y
Matsukawa
Hiroyoshi
H
Aoki
Hideki
H
Shiozaki
Shigehiro
S
Ohno
Satoshi
S
Takakura
Norohisa
N
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