Splenectomy as part of primary cytoreductive surgery for advanced ovarian cancer: a retrospective cohort study.
BACKGROUND
The aim of surgical approach in advanced ovarian cancer should be the complete removal of all visible disease. Our purpose was to compare perioperative features and postoperative complications, and secondarily oncological outcomes, between patients who underwent splenectomy and those who did not at the time of surgery.


METHODS
Thirty-three subjects underwent splenectomy, and we selected 99 controls with similar surgical characteristics but who did not undergo splenectomy. Data collected included perioperative details and follow-up data.


RESULTS
Longer operating time (33 minutes longer; P = 0.02), larger estimated blood loss (812 mL more; P = 0.03), higher rate of intraoperative blood transfusions (78.8% vs 42.4%; P < 0.01), and intensive care unit stay (1.4 vs 0.5 days; P < 0.01) as well as higher pneumonia rate (2% vs 0%; P = 0.01) were observed in the splenectomy group. Disease-free and overall survival rates were 30.3% and 66.6%, respectively, in the splenectomy group, and 33.3% and 59.6%, respectively, in the control group.


CONCLUSIONS
Splenectomy at the time of primary cytoreductive surgery for advanced ovarian cancer may contribute to achieve complete cytoreduction with low perioperative complication rate. This procedure seems to be an acceptable and rational intervention to increase the survival rates of those patients.
Gynecologic Oncology Department, European Institute of Oncology, Milan, Italy. ignaciozapardiel@hotmail.com
Ignacio
I
Zapardiel
Michele
M
Peiretti
Vanna
V
Zanagnolo
Roberto
R
Biffi
Luca
L
Bocciolone
Fabio
F
Landoni
Giovanni
G
Aletti
Nicoletta
N
Colombo
Angelo
A
Maggioni
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000401:mortality / Q000601:surgery*; D059035:Perioperative Period / Q000706:statistics & numerical data; D011014:Pneumonia / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013156:Splenectomy; D016896:Treatment Outcome