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Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer
Open accessAbstract
Background: Preservation or removal of the spleen during total gastrectomy for proximal gastric cancer is a matter of debate. Methods: A randomized clinical trial included patients with gastric adenocarcinoma who underwent total gastrectomy either with (104 patients) or without (103) splenectomy. Postoperative outcome in the two groups was compared, including morbidity, mortality and survival. Results: Gastrectomy combined with splenectomy tended to be associated with slightly higher morbidity and mortality rates, a slightly greater incidence of lymph node metastasis at the splenic hilum and along the splenic artery, and marginally better survival, but there were no statistically significant differences between the groups. Splenectomy had no impact on survival in patients with metastatic lymph nodes at the hilum of the spleen or in those with metastatic lymph nodes along the splenic artery. Conclusion: These results do not support the use of prophylactic splenectomy to remove macroscopically negative lymph nodes near the spleen in patients undergoing total gastrectomy for proximal gastric cancer.
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Cited by
Songun, I., Putter, H., Kranenbarg, E. M.-K., Sasako, M., & van de Velde, C. J. (2010) · The Lancet Oncology · doi:10.1016/s1470-2045(10)70070-x · Cited by 1,765
Ajani, J. A., Lee, J., Sano, T., Janjigian, Y. Y., Fan, D., & Song, S. (2017) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2017.36 · Cited by 594
Catalano, V., Labianca, R., Beretta, G. D., Gatta, G., de Braud, F., & Van Cutsem, E. (2009) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2009.01.004 · Cited by 365
Sano, T., Sasako, M., Mizusawa, J., Yamamoto, S., Katai, H., Yoshikawa, T., Nashimoto, A., Ito, S., Kaji, M., Imamura, H., et al. (2017) · Annals of Surgery · doi:10.1097/sla.0000000000001814 · Cited by 323
Metadata
- Authors
- Yu, W., Choi, G. S., & Chung, H. Y.
- Venue
- British Journal of Surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-04-11
- Volume
- 93
- Issue
- 5
- Pages
- 559-563
- ISSN
- 0007-1323 (ISSN-L)
- 1365-2168
- OpenAlex
- W2096858740
- Cited by
- 246
- References
- 0
- FWCI
- 8.32
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Yu, W., Choi, G. S., & Chung, H. Y. (2006). Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer. British Journal of Surgery. https://doi.org/10.1002/bjs.5353
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