Impact of splenectomy for lymph node dissection on long-term surgical outcome in gastric cancer

Background: In the treatment of gastric cancer, splenectomy is performed fo r effective lymph. node dissection around the splenic artery and splenic hi lum. The purpose of this study was to clarify the long-term outcome of sple nectomy in the treatment of gastric cancer. Methods: The effect of splenectomy on recurrence and prognosis was examined in a retrospective analysis of 665 patients who had undergone curative tot al gastrectomy for gastric carcinoma from 1987 to 1996. The risk factors as sociated with recurrence and prognosis were investigated by univariate and multivariate analysis. Results: The splenectomy group showed more advanced lesions and a higher re currence rate than the spleen-preserved group. However, after adjusting for the TNM (tumor, node, metastasis) stage, there was no significant differen ce in recurrence rate and pattern between the two groups. Logistic regressi on analysis revealed that gross type, serosal invasion, and nodal metastasi s were independent risk factors for recurrence while splenectomy was not. W hen comparing patients with the same TNM (tumor, node, metastasis) stages, no significant difference in the 5-year survival rates was apparent. Multiv ariate analysis demonstrated that age, serosal invasion, and nodal metastas is were independent prognostic factors whereas splenectomy was not. Conclusions: These data suggest that splenectomy for lymph node dissection in gastric cancer is not effective regarding long-term patient prognosis.