Evidence map›Paper›PMID 39710775›Full record

ArticleLangenbeck's archives of surgery2024

A retrospective, multicentric, nationwide analysis of the impact of splenectomy on survival of pancreatic cancer patients.

Maximilian Kießler, Carsten Jäger, Carmen Mota Reyes, Ilaria Pergolini, Stephan Schorn, Rüdiger Göß, Okan Safak, Marc E Martignoni, Alexander R Novotny, Waldemar Uhl and 27 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

37 authors.

Maximilian KießlerDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Carsten JägerDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Carmen Mota ReyesDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Ilaria PergoliniDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Stephan SchornDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Rüdiger GößDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Okan SafakDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Marc E MartignoniDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Alexander R NovotnyDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Waldemar UhlDepartment of General and Visceral Surgery, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany.
Jens WernerDepartment of General, Visceral, and Transplant Surgery, LMU University Hospital of Munich, Munich, Germany.
Michael GhadimiDepartment of General-, Visceral-, and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.
Werner HartwigDepartment of General and Visceral Surgery, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany.
Reinhard RuppertDepartment of General and Visceral Surgery, Endocrine Surgery, and Coloproctology, Municipal Hospital of Munich-Neuperlach, Munich, Germany.
Tobias KeckDepartment of Surgery, University Hospital of Schleswig Holstein (UKSH), Lübeck, Germany.
Christiane J BrunsDepartment of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Cologne, Germany.
Karl-Jürgen OldhaferDepartment Für Chirurgie, Klinik Für Leber-, Gallenwegs- Und Pankreaschirurgie, Asklepios Klinik Barmbek, Hamburg, Germany.
Andreas SchnitzbauerClinic for General and Visceral Surgery, University Hospital Frankfurt, Goethe-University, Frankfurt/Main, Germany.
Christoph-Thomas GermerDepartment of General, Visceral, Transplantation, Vascular and Pediatric Surgery, Center of Operative Medicine (ZOM), University Hospital of Wuerzburg, Würzburg, Germany.
Florian SommerDepartment of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Augsburg, Germany.
Sören Torge MeesDepartment of General and Visceral Surgery, Dresden-Friedrichstadt General Hospital, Dresden, Germany.
Maximilian BrunnerDepartment of Surgery, University Hospital Erlangen, Erlangen, Germany.
Jörg KöningerDepartment of General, Visceral, Thoracic, and Transplantation Surgery, Klinikum Stuttgart, Stuttgart, Germany.
Tim R GlowkaDepartment of Surgery, University Hospital of Bonn, Bonn, Germany.
Jörg C KalffDepartment of Surgery, University Hospital of Bonn, Bonn, Germany.
Christoph ReißfelderDepartment of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Germany; Department of Surgery, University Medicine Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Detlef K BartschDepartment of Visceral, Thoracic and Vascular Surgery, Philipps-University Marburg, Marburg, Germany.
Thomas KrausHospital Nordwest GmbH, Frankfurt, Germany.
Winfried PadbergDepartment of General & Thoracic Surgery, University Hospital of Giessen, Giessen, Germany.
Pompiliu PisoDepartment of General and Visceral Surgery, Hospital Barmherzige Brüder, Regensburg, Germany.
Bernhard J LammersDepartment of General Surgery, Endocrine Surgery, Abdominal Surgery, Thorax Surgery, Vascular Surgery, Colorectal and Hernia Surgery, Lukaskrankenhaus GmbH, Neuss, Germany.
Hagen RudolphDepartment of General Und Visceral Surgery, Klinikum Chemnitz gGmbH, Chemnitz, Germany.
Christian MoenchDepartment of General, Visceral, and Transplantation Surgery, Westpfalz-Klinikun GmbH, Kaiserslautern, Germany.
Stefan FarkasDepartment of General Und Visceral Surgery, St. Josefs-Hospital, Wiesbaden, Germany.
Helmut FriessDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Güralp O CeyhanDepartment of General Surgery, HPB-Unit, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Ihsan Ekin DemirDepartment of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. ekin.demir@tum.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSplenectomy is regularly performed in total and distal pancreatectomy due to technical reasons, lymph node dissection and radicality of the operation. However, the spleen serves as an important organ for competent immune function, and its removal is associated with an increased incidence of cancer and a worse outcome in some cancer entities (Haematologica 99:392-398, 2014; Dis Colon Rectum 51:213-217, 2008; Dis Esophagus 21:334-339, 2008). The impact of splenectomy in pancreatic cancer is not fully resolved (J Am Coll Surg 188:516-521, 1999; J Surg Oncol 119:784-793, 2019).

methodsWe therefore compared the outcome of 193 pancreatic cancer patients who underwent total or distal pancreatectomy with (Sp) or without splenectomy (NoSp) between 2015 and 2021 using the StuDoQ|Pancreas registry of the German Society for General and Visceral Surgery. In addition, we integrated our data into the existing literature in a meta-analysis of studies on splenectomy in pancreatic cancer patients.

resultsThere was no difference between the Sp and NoSp groups regarding histopathological parameters, number of examined or affected lymph nodes, residual tumor status, or postoperative morbidity and mortality. We observed a significantly prolonged survival in pancreatic cancer patients who underwent total pancreatectomy, when a spleen-preserving operation was performed (median survival: 9.6 vs. 17.3 months, p = 0.03). In this group, splenectomy was identified as an independent risk factor for shorter overall survival [HR (95%CI): 2.38 (1.03 - 6.8)]. In a meta-analysis of the existing literature in combination with our data, we confirmed splenectomy as a risk factor for a shorter overall survival in pancreatic cancer patients undergoing total pancreatectomy, distal pancreatectomy, or pancreatic head resection [HR (95%CI): 1.53 (1.11 - 1.95)].

conclusionHere, we report on a strong correlations between removal of the spleen and the survival of pancreatic cancer patients undergoing total pancreatectomy. This should encourage pancreatic surgeons to critically assess the role of splenectomy in total pancreatectomy and give rise to further investigations.

Indexed as

Pancreatic NeoplasmsSplenectomyAdultAgedAged, 80 and overFemaleGermanyHumansMaleMiddle AgedPancreatectomyRetrospective StudiesSurvival RateDistal pancreatectomyPancreatic cancerSplenectomyTotal pancreatectomy

Identifiers

PMID39710775
PMCPMC11663811

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