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Radical gastrectomy with combined splenectomy: unnecessary.

UNLABELLED
BACKROUND/AIMS: To analyze the prognostic value of gastric cancer surgery combined with splenectomy for gastric cancer patients.


METHODOLOGY
Retrospective study was performed on 112 patients who underwent radical gastrectomy for upper third, upper and middle third, and entire stomach cancer, 61 patients underwent spleen-preserving modified radical lymphadenectomy (spleen-preservation group), and the remaining 51 patients underwent D2 radical lymphadenectomy with splenectomy (splenectomy group). Postoperative morbidity rate and the 5-year survival rate were compared.


RESULTS
There was no significant difference between the spleen-preservation group and splenectomy group in gender, age, tumor size, T stage, N stage and TNM stage. The overall 5-year survival rate was 41.0% in the spleen-preservation group, compared with 39.2% in the splenectomy group (p>0.05). The 5-year survival rate of patients in the spleen-preservation group vs splenectomy group was 100% vs 100.0% for stage I, 66.7% vs 70.0% for stage II, 27.8% vs 26.7% for stage III, and 17.4% vs 5.6%for stage IV, respectively (p>0.05). There was a significant difference (p<0.05) in postoperative morbidity rate (11.5% for spleen-preservation group vs 27.5% in the splenectomy group).


CONCLUSION
Lower postoperative morbidity but similar 5-year survival rate was observed in spleen-preserving modified radical lymphadenectomy group compared to D2 radical lymphadenectomy with splenectomy.