Dr Jian Guo Shen and colleagues from Korea investigated the interactions between splenectomy and perioperative transfusion in gastric cancer.
The investigative team reviewed medical records of 449 gastric cancer patients who had undergone total gastrectomies for curative intent between 1991 and 1995.
The influence of splenectomy on tumor recurrence and survival in transfused and nontransfused patients were evaluated by univariate and multivariate analysis.
|Recurrence rate with splenectomy and transfusion was 48%|
|American Journal of Surgery|
The investigators found that the recurrence rate in the splenectomy group was 48% vs 23% in the spleen-preserved group among transfused patients.
In the nontransfused patients, the recurrence rate was 41% with splenectomy compared with 27% in the spleen-preserved group.
The team noted no difference in the mean survival between the splenectomy group and the spleen-preserved group in a subgroup analysis by stage.
Multivariate analysis identified splenectomy as an independent risk factor for recurrence but not as a predictor for survival among transfused patients.
Dr Shen's team concluded, “Splenectomy does not appear to abrogate the adverse effect of perioperative transfusion on prognosis in gastric cancer patients.”
“Moreover, it may increase postoperative recurrence in transfused patients.”