Splenectomy in cancer gastrectomy: recommendation of spleen-preserving for early stages.

Abstract The prognostic significance of splenectomy in cancer gastrectomy was reevaluated, in terms of postoperative survival rate, retrospectively. The cumulative survival rates between a splenectomized group (n = 272) and a nonsplenectomized group (n = 192) were compared. The five-, ten- and fifteen-year survival rates were significantly higher in the nonsplenectomized group in total. When the cancer was classified, according to intraoperative gross findings of the degree of serosal invasion, penetration into adjacent organs and metastases, the five-year cumulative survival rate for Stage I and II patients was significantly higher in the nonsplenectomized group. No significant difference was found between the two groups of Stage II in any of the one- to fifteen-year survival rates. The one-year survival rate for Stage IV patients in the splenectomized group was higher than that in the nonsplenectomized group. The splenectomy should be limited to the Stage III or IV patients with some specific findings.