Bedeutung der Splenektomie im Rahmen der operativen Behandlung des Magenkarzinoms.

Background: The value of simultaneous splenectomy as part of an oncologically adequate resection for gastric cancer has been controversially discussed over the last decades. Methods: As part of a prospective multicenter observational study data were obtained from patients admitted to hospital with histologically diagnosed primary gastric cancer or adenocarcinoma of the esophagogastric junction (AEG). The profiles of care of patients who had undergone surgical treatment in 141 surgical departments from 1 January 2007 to 31 December 2009 were collated. Overall, 2897 patients were enrolled in the study (tumor resection, n = 2545). Results: The overall splenectomy rate was 11.1% (n = 283) and the highest proportion was found in AEG tumor lesions (19.4%). In the whole group of patients as well as depending on the tumor site, there was a higher preoperative comorbidity in splenectomized patients. While the rate of general postoperative complications after splenectomy was significantly increased in all patients and also depending on various tumor sites, there were no differences in the rate of specific postoperative complications. A significantly higher hospital mortality comparing the splenectomy group of patients with those in whom the spleen could be preserved, was only observed in AEG-associated tumor lesions (15.2% vs. 5.0%). All splenectomized patients showed a shorter long-term survival (p < 0.001) compared to resections with a preserved spleen (18 months vs. 36 months). Conclusion: In the surgical treatment of gastric cancer, splenectomy can be considered a negative predictor for a worse perioperative outcome and a worse long-term survival. [ABSTRACT FROM AUTHOR]