Correlation between macroscopic and microscopic diseases on splenectomies performed in the surgical management of ovarian cancer.
BACKGROUND
Surgical management of primary or recurrent ovarian cancer with extensive upper abdominal disease may require splenectomy to achieve complete cytoreduction. The aims of this series were to correlate the macroscopic exploration with the microscopic analysis of the spleen and to evaluate the morbidity of patients submitted to this procedure for primary and recurrent disease.


METHODS
Data concerning patients who underwent splenectomy at the time of management of the primary (initial group) or recurrent disease were reviewed. The characteristics and survival of patients were analyzed. The correlation between macroscopic suspected lesion and histological results and morbidity according to the Dindo classification was studied.


RESULTS
From 1995 to 2008, 58 patients (42 in the initial group and 16 in the recurrence group) underwent a splenectomy in our institution. Except for 3 cases requiring splenectomy for hemostatic reasons, the macroscopically suspected splenic lesion was confirmed by histology in 32 (80%) of 40 cases in the initial group and in 14 (93%) of 15 cases in the recurrence group. Eighteen patients (26.5%) had a morbidity grade strictly superior to 2, and in all the factors we tested, only pelvic posterior exenteration was a risk factor for high morbidity (P = 0.02).


CONCLUSIONS
When splenic lesions are macroscopically suspected during cytoreductive surgery for an ovarian cancer, most of the time the disease is confirmed by histology. When required to accomplish complete cytoreduction, splenectomy seemed to be justified.
Uzan
Catherine
C
Department of Gynecologic Surgery, Institut Gustave Roussy, Villejuif, France.
Bontoux
Laure-Marie
LM
Gouy
Sebastien
S
Duvillard
Pierre
P
Pautier
Patricia
P
Lhommé
Catherine
C
Morice
Phillippe
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D001707:Biopsy, Needle; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D010052:Ovariectomy; D012189:Retrospective Studies; D018570:Risk Assessment; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000473:pathology* / Q000556:secondary; D016019:Survival Analysis; D047368:Tumor Burden