Splenectomy in epithelial ovarian cancer surgery

ObjectiveSplenectomy is performed in 4-32% of cytoreductive surgeries for ovarian cancer. The objective of our study was to assess splenectomy and evaluate its impact on overall and disease-free survival. MethodsWe conducted a retrospective single-center study between January 2000 and December 2016. Patients who underwent a cytoreduction for epithelial ovarian cancer, regardless of stage and surgical approach, were eligible for the study. Patients deemed not operable were excluded from the study. Patients were stratified into two groups, splenectomy or no splenectomy. A univariate analysis followed by a multivariate analysis was conducted to evaluate the postoperative complications after splenectomy and the overall and disease-free survival. ResultsThis cohort included 464 patients. Disease stages, peritoneal carcinomatosis scores, and the rate of radical surgery (Pomel classification) were significantly higher in the splenectomy group, p=0.04, p<0.0001, and p<0.001, respectively. However, no significant difference was found in the rate of complete cytoreduction between the two groups (p=0.26) after multivariate analysis. In univariate analysis, splenectomy was significantly associated with extensive surgical procedures. In multivariate analysis, the two more prevalent complications in the splenectomy group were the risk of abdominopelvic lymphocele (overall response (OR) =4.2; p=0.01) and blood transfusion (OR=2.4; p=0.008). The average length of hospital stay was significantly longer in the splenectomy group, 17.4 vs 14.6 days (p<0.0001). The delay in adjuvant chemotherapy was longer in the splenectomy group (p=0.001). There was no significant difference in overall and disease-free survival (p=0.09) and (p=0.79), respectively. ConclusionSplenectomy may be considered an acceptable and safe procedure; however, with no impact on overall or disease-free survival. In addition, it is associated with longer hospital stay and longer time to chemotherapy.

Automated summary

ObjectiveSplenectomy is performed in a significant percentage of cytoreductive surgeries for ovarian cancer. This study aimed to evaluate the impact of splenectomy on overall and disease-free survival in patients with epithelial ovarian cancer. MethodsA retrospective study was conducted on patients who underwent cytoreduction for ovarian cancer between January 2000 and December 2016. Patients were stratified into splenectomy and non-splenectomy groups, and postoperative complications and survival outcomes were analyzed. ResultsA total of 464 patients were included in the study. The splenectomy group had higher disease stages, peritoneal carcinomatosis scores, and radical surgery rates. However, there was no significant difference in complete cytoreduction rates between the two groups. Splenectomy was associated with extensive surgical procedures and increased risk of abdominopelvic lymphocele and blood transfusion. The average length of hospital stay and delay in adjuvant chemotherapy were longer in the splenectomy group. Overall and disease-free survival rates were not significantly different between the groups. ConclusionSplenectomy may be a safe procedure with no impact on overall or disease-free survival in patients with ovarian cancer. However, it is associated with longer hospital stay and delay in chemotherapy.