Prognostic Impact of Splenectomy in Patients with Esophagogastric Junction Carcinoma.

BACKGROUND/AIM:We evaluated the survival benefit of splenectomy in patients with esophagogastric junction (ECJ) carcinoma.PATIENTS AND METHODS:We retrospectively examined clinicopathological and survival data for 60 surgically-treated patients with ECJ carcinoma.RESULTS:The 5-year overall survival (OS) rate was 47%. Splenectomy was performed in 20 patients (30%). Multivariate Cox regression analysis revealed splenectomy (odds ratio (OR), 2.70; 95% confidence interval (CI)=1.06-7.17; p=0.04) and venous invasion (OR=3.03; 95%CI=1.20-9.27; p=0.02) as significant independent predictors of poorer OS. Splenic hilar lymph node metastasis was not observed. Multivariate logistic regression analysis identified perioperative blood transfusion (BTF) as a significant independent factor associated with splenectomy.CONCLUSION:The survival benefit of splenectomy in ECJ carcinoma patients may decrease with increasing frequency of perioperative BTF for blood loss. We recommend that splenectomy should be performed carefully when indicated by the extent or invasion of EGJ carcinoma.