Value of Splenectomy in Patients with Siewert Type II Adenocarcinoma of the Esophagogastric Junction

Overview

Journal Gastric Cancer

Specialties Gastroenterology
Oncology

Date 2012 Nov 27

PMID 23179369

Citations 22

Authors

Hironobu Goto

Masanori Tokunaga

Norihiko Sugisawa

Yutaka Tanizawa

Etsuro Bando

Taiichi Kawamura

Masahiro Niihara

Yasuhiro Tsubosa

Masanori Terashima

Affiliations

Soon will be listed here.

Abstract

Background: The incidence of adenocarcinoma of the esophagogastric junction (AEG) has been increasing recently in both Western and Eastern countries. However, an optimal treatment strategy for Siewert type II AEG is still unclear. The aim of this study was to clarify the value of splenectomy in patients with Siewert type II AEG.

Methods: From September 2002 to November 2011, 42 patients underwent total gastrectomy with D2 lymph node dissection for Siewert type II AEG and were included in this study. We used the index of estimated benefit from lymph node dissection (IEBLD) to assess the efficacy of lymph node dissection of each station. Surgical complications were graded by the Clavien-Dindo classification.

Results: The overall 5-year survival rate of the 42 patients was 57.5 %. The incidence of splenic hilar lymph node metastasis was 4.8 % and the 5-year survival rate of patients with splenic hilar lymph node involvement was zero. Consequently, the IEBLD of splenic hilar lymph nodes was zero. Postoperative morbidities occurred in 25 patients (59.5 %). Pancreas-related complications were the most frequently observed (28.5 %), followed by intraabdominal abscess (14.3 %) and anastomotic leakage (9.5 %).

Conclusions: Splenic hilar lymph node dissection may be omitted without decreasing curability in patients with Siewert type II AEG, although a prospective study is necessary for more conclusive results.

Citing Articles

Therapeutic value of lymph node dissection for Siewert type II and III adenocarcinoma: meta-analysis.

Chen X, Chen Q, Xu R, Zhao F BJS Open. 2024; 8(1).

PMID: 38180912 PMC: 10768987. DOI: 10.1093/bjsopen/zrad138.

Mapping of lymph node dissection determined by the epicenter location and tumor extension for esophagogastric junction carcinoma.

Liang R, Bi X, Fan D, Du Q, Wang R, Zhao B Front Oncol. 2022; 12:913960.

PMID: 36518305 PMC: 9743047. DOI: 10.3389/fonc.2022.913960.

Efficacy of the No. 10 lymphadenectomy with spleen preservation on patients with gastric cancer and/or esophagogastric junction adenocarcinoma who underwent total gastrectomy: a systematic review and meta-analysis.

Xia B, Wang C, Liu Y, Fan Y, He X, Kang Y Transl Cancer Res. 2022; 11(9):3024-3038.

PMID: 36237234 PMC: 9552271. DOI: 10.21037/tcr-22-522.

Clinical Relevance of Splenic Hilar Lymph Node Dissection for Proximal Gastric Cancer: A Propensity Score-Matching Case-Control Study.

Lin J, Wang Z, Huang Y, Xie J, Wang J, Lu J Ann Surg Oncol. 2021; 28(11):6649-6662.

PMID: 33768400 DOI: 10.1245/s10434-021-09830-1.

Systemic Review and Meta-analysis of Impact of Splenectomy for Advanced Gastric Cancer.

Kunisaki C, Sato S, Tsuchiya N, Watanabe J, Sato T, Takeda K In Vivo. 2020; 34(6):3115-3125.

PMID: 33144415 PMC: 7811676. DOI: 10.21873/invivo.12145.

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