ArticlePloS one2018
Adverse prognostic impact of splenectomy on survival in gastric carcinoma patients: Regression and propensity score matching analysis of 1074 patients.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022 Guideline).Journal of gastric cancer · 2025Guideline
- Splenectomy as a part of cytoreductive surgery in ovarian cancer: systematic review and meta-analysis.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2024Pooled it
- Systemic Review and Meta-analysis of Impact of Splenectomy for Advanced Gastric Cancer.In vivo (Athens, Greece)Pooled it
- Splenic hilar lymph node dissection enhances survival in Bormann type 4 gastric cancer.Scientific reports · 2023Article
- Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach.Journal of gastric cancer · 2023Review
- Oncologic outcomes after splenectomy during initial cytoreductive surgery in advanced epithelial ovarian cancer: a nationwide population-based cohort study.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Is splenic hilar lymph node dissection necessary for proximal gastric cancer surgery?Annals of gastroenterological surgery · 2021Review
- Analysis of the Factors Affecting Survival in the Patients who Underwent Curative-Intent Gastrectomy due to Gastric Adenocarcinoma.Sisli Etfal Hastanesi tip bulteni · 2021Article
- The Retropancreatic Fusion Fascia Oriented Splenic Hilar Lymphadenectomy Versus Laparoscopic Approach In D2 Total Gastrectomy.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- Disadvantages of Complete No. 10 Lymph Node Dissection in Gastric Cancer and the Possibility of Spleen-Preserving Dissection: Review.Journal of gastric cancer · 2020Review
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundsPatients with proximal gastric carcinoma undergo total gastrectomy with concomitant splenectomy to ensure the complete removal of splenic hilar lymph nodes. However, the impact of splenectomy on survival remains uncertain. This study aimed to investigate the impact of splenectomy on survival among patients with gastric carcinoma.
methodsOf 1074 patients who underwent total gastrectomy for proximal gastric carcinoma between 2006 and 2014, 229 patients underwent concomitant splenectomy or pancreaticosplenectomy during surgery. We investigated the prognostic impact of splenectomy using a regression and propensity score matched model.
resultsThe splenectomy and non-splenectomy groups differed in many baseline characteristics, including tumor stage, and had respective crude 5-year survival rates of 55% and 81% (p <0.001). In a multivariate analysis adjusted for TNM stage and other prognostic factors, splenectomy was an independent poor prognostic factor for overall survival (hazard ratio [HR] = 1.67, 95% confidence interval [CI] = 1.11-2.51) and disease-free survival (HR = 1.61, 95% CI = 1.24-2.10). A survival evaluation stratified by TNM stage showed that splenectomy adversely affected survival among patients with stage III, but not stage I, II, and IV disease. In the propensity score-matched sample, splenectomy group also showed significantly worse overall survival (5-year, 65% vs. 79%, p = 0.010) and disease-free survival (5-year, 55% vs. 72%, p = 0.025) and was an independent poor prognostic factor in a multivariate analysis adjusting TNM stage and other prognostic factors.
conclusionsSplenectomy adversely affects survival, particularly among patients with stage III gastric carcinoma, and should be avoided unless there is direct invasion to the splenic hilum.
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