title: Prognostic impact of prophylactic splenectomy for upper-third gastric cancer: a cohort study.
abstract: OBJECTIVE
  The aim of this study was to investigate the effect of splenectomy on survival outcomes and recurrence in patients who underwent curative surgery for gastric cancer.
  
  
  METHODS
  This is a retrospective study of 129 patients who underwent upper-third gastric cancer curative resection with lymphadenectomy. Forty-two patients (32%) also underwent splenectomy.
  
  
  RESULTS
  The median follow-up period was 33 months. Approximately 40% of the patients had lymph node metastases; four of them had nodal involvement along the splenic artery and 5 had nodal involvement at the splenic hilum. No patients in the pT1-2 group with nodal metastases had involvement of the splenic hilar lymph nodes. There was no significant association between splenectomy and either overall or disease-free survival in the patients.
  
  
  CONCLUSIONS
  Splenectomy should not be performed in patients with pT1-2 tumors for prophylactic lymphadenectomy.
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, Japan. h.ito@med.showa-u.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ito
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue
authors.forename: Noriko
authors.initials: N
authors.lastname: Odaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Satodate
authors.forename: Shumpei
authors.initials: S
authors.lastname: Mukai
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Omoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takehara
authors.forename: Shin-Ei
authors.initials: SE
authors.lastname: Kudo
mesh_terms: D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D013154:Spleen / Q000473:pathology / Q000601:surgery; D013156:Splenectomy / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*