Effect of splenectomy on the survival of patients underwent radical surgery for gastric cardia cancer

Aims: In gastric cardia cancer, the spleen is usually removed when the tumor is resected. This allows thorough lymph node dissection in the splenic hilus. However, the effect of splenectomy on patient survival is controversial. This study gives insight into the effect of splenectomy in radical surgery for gastric cardia cancer. Methodology: We reviewed the records of 348 patients who underwent radical resection for gastric cardia cancer. Of these 348 patients, 105 underwent splenectomy and 243 had splenic preservation. The clinicopathologic features of 105 patients underwent gastrectomy combined with resection of the spleen (splenectomy group) and 243 patients underwent gastrectomy (spleen-preservation group) were compared. Results: Gastric cardia cancer with splenectomy was characterized by serosal invasion, and positive lymph node metastasis. For age, sex, and tumor size, there was no significant difference between the patients with splenectomy and spleen-preservation. The 5-year survival of splenectomy group was 20.8% as compared with 30.5% for spleen-preservation group. With respect to patients with splenectomy, multivariate analysis showed that lymph node metastasis was significant factors affecting survival. Conclusions: Compared with spleen-preservation group, patients who underwent gastrectomy combined with splenectomy have a greater chance of serosal invasion, and positive lymph node metastasis and a significantly poor prognosis.