Presented at the 2006 Gastrointestinal Cancers Symposium, 26–28 January 2006 San Francisco, USA, Presented at the European Society of Esophagology (GEEMO) Meeting, 30/11–2/12 2006 Leuven, Belgium.
Impact of splenectomy on surgical outcome in patients with cancer of the distal esophagus and gastro-esophageal junction
Article first published online: 17 AUG 2007
© 2007 The Authors. Journal compilation © 2007 The International Society for Diseases of the Esophagus
Diseases of the Esophagus
Volume 21, Issue 4, pages 334–339, June 2008
How to Cite
Pultrum, B. B., Van Bastelaar, J., Schreurs, L. M. A., Van Dullemen, H. M., Groen, H., Nijsten, M. W. N., Van Dam, G. M. and Plukker, J. T. H. M. (2008), Impact of splenectomy on surgical outcome in patients with cancer of the distal esophagus and gastro-esophageal junction. Diseases of the Esophagus, 21: 334–339. doi: 10.1111/j.1442-2050.2007.00762.x
- Issue published online: 17 AUG 2007
- Article first published online: 17 AUG 2007
- esophageal cancer;
- lymph node dissection;
SUMMARY. We aim to determine the effect of splenectomy on clinical outcome in patients with cancer of the distal esophagus and gastro-esophageal junction (GEJ) after a curative intended resection. From January 1991 to July 2004, 210 patients underwent a potentially curative gastroesophageal resection with an extended nodal dissection. The study group was divided into: group I with splenectomy, consisting of 66 patients (31.4%), and group II without splenectomy, of 144 patients. Splenectomy was performed for oncological reasons. Medical records were reviewed retrospectively. Postoperative complications occurred in 27 patients (40.9%) in group I and in 68 patients (47.2%) in group II (P = 0.4). The overall mortality was not significantly different between both groups (P = 0.7). There was a higher administration of red blood cells during surgery (P ≤ 0.001), increased operating room (OR) time (P ≤ 0.001) and longer intensive care unit (ICU) stay (P = 0.01) in group I. Independent prognostic factors for survival were outcome of surgery, nodal metastases, gender, complications and ICU stay. Sepsis was a strong prognostic factor among the complications. The 1 and 2-year survival was significantly higher in group II; 75% and 67% (P = 0.032) compared to 69% and 56% (P = 0.017) in group I, respectively. However, the 5-year survival was not different in both groups (29% in group I and 60% in group II, P = 0.191). Splenectomy had no marked effect on mortality and morbidity after curative resection of esophageal cancer. Splenectomy had a significant increase in blood transfusions with prolonged OR time and ICU stay and decreased short-term survival.