Impact of splenectomy on long-term outcomes after gastrectomy for gastric cancer: a population-based study

Anna Junttila; Olli Helminen; Mika Helmiö; Heikki Huhta; Aapo Jalkanen; Raija Kallio; Vesa Koivukangas; Arto Kokkola; Simo Laine; Elina Lietzen; Johanna Louhimo; Sanna Meriläinen; Vesa Matti Pohjanen; Tuomo Rantanen; Ari Ristimäki; Jari V. Räsänen; Juha Saarnio; Eero Sihvo; Vesa Toikkanen; Tuula Tyrväinen; Antti Valtola; Joonas H. Kauppila

doi:10.1016/j.gassur.2024.10.009

Impact of splenectomy on long-term outcomes after gastrectomy for gastric cancer: a population-based study

Anna Junttila, Olli Helminen, Mika Helmiö, Heikki Huhta, Aapo Jalkanen, Raija Kallio, Vesa Koivukangas, Arto Kokkola, Simo Laine, Elina Lietzen, Johanna Louhimo, Sanna Meriläinen, Vesa Matti Pohjanen, Tuomo Rantanen, Ari Ristimäki, Jari V. Räsänen, Juha Saarnio, Eero Sihvo, Vesa Toikkanen, Tuula TyrväinenAntti Valtola, Joonas H. Kauppila

Research output: Contribution to journal › Article › Scientific › peer-review

1 Citation (Scopus)

5 Downloads (Pure)

Abstract

Background: No national studies comparing long-term survival after total or partial gastrectomy with splenectomy due to injury or oncologic reasons or spleen preservation exist. This study aimed to examine the 5-year overall survival (OS) of patients with gastric adenocarcinoma who underwent total or partial gastrectomy with splenectomy due to injury or oncologic reasons or spleen preservation in a population-based nationwide setting. Methods: This study included all patients undergoing total or partial gastrectomy with splenectomy or spleen preservation for gastric adenocarcinoma in Finland from 2005 to 2016, with follow-up until December 31, 2019. A total of 2196 patients with gastric cancer diagnosis and total or partial gastrectomy were identified in the registries. Of these patients, 2118 were applicable for this study. Cox proportional hazard models provided hazard ratios (HRs) with 95% CIs of 5-year OS. The results were adjusted for age, sex, year of operation, comorbidities, tumor location, pathologic stage, and neoadjuvant therapy. Results: The observed 5-year OS rates were 38.7% in patients with no or minor spleen injury, 39.7% in patients with splenectomy due to injury, and 30.8% in patients with splenectomy due to oncologic reasons (P = .032). Patients who underwent R0 gastrectomy with splenectomy due to oncologic reasons had higher 5-year mortality (the adjusted model HR, 1.26; 95% CI, 1.01–1.56) than patients who underwent spleen preservation. Conclusion: The OS was worst in patients who underwent gastrectomy with splenectomy due to oncologic reasons, highlighting the poor prognosis in patients with advanced gastric cancer. Splenectomy due to injury does not compromise the prognosis.

Original language	English
Pages (from-to)	2090-2096
Number of pages	7
Journal	Journal of Gastrointestinal Surgery
Volume	28
Issue number	12
DOIs	https://doi.org/10.1016/j.gassur.2024.10.009
Publication status	Published - 2024
Publication type	A1 Journal article-refereed

Keywords

Gastrectomy
Gastric adenocarcinoma
Postoperative complication
Splenectomy

Publication forum classification

Publication forum level 1

ASJC Scopus subject areas

Surgery
Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.gassur.2024.10.009Licence: CC BY

1-s2.0-S1091255X2400670X-mainFinal published version, 589 KBLicence: CC BY

https://urn.fi/URN:NBN:fi:tuni-2024123011727Licence: CC BY

Cite this

Junttila, A., Helminen, O., Helmiö, M., Huhta, H., Jalkanen, A., Kallio, R., Koivukangas, V., Kokkola, A., Laine, S., Lietzen, E., Louhimo, J., Meriläinen, S., Pohjanen, V. M., Rantanen, T., Ristimäki, A., Räsänen, J. V., Saarnio, J., Sihvo, E., Toikkanen, V., ... Kauppila, J. H. (2024). Impact of splenectomy on long-term outcomes after gastrectomy for gastric cancer: a population-based study. Journal of Gastrointestinal Surgery, 28(12), 2090-2096. https://doi.org/10.1016/j.gassur.2024.10.009

@article{63cd2f5cf18449d6ba2ffd9e103e84e0,

title = "Impact of splenectomy on long-term outcomes after gastrectomy for gastric cancer: a population-based study",

abstract = "Background: No national studies comparing long-term survival after total or partial gastrectomy with splenectomy due to injury or oncologic reasons or spleen preservation exist. This study aimed to examine the 5-year overall survival (OS) of patients with gastric adenocarcinoma who underwent total or partial gastrectomy with splenectomy due to injury or oncologic reasons or spleen preservation in a population-based nationwide setting. Methods: This study included all patients undergoing total or partial gastrectomy with splenectomy or spleen preservation for gastric adenocarcinoma in Finland from 2005 to 2016, with follow-up until December 31, 2019. A total of 2196 patients with gastric cancer diagnosis and total or partial gastrectomy were identified in the registries. Of these patients, 2118 were applicable for this study. Cox proportional hazard models provided hazard ratios (HRs) with 95% CIs of 5-year OS. The results were adjusted for age, sex, year of operation, comorbidities, tumor location, pathologic stage, and neoadjuvant therapy. Results: The observed 5-year OS rates were 38.7% in patients with no or minor spleen injury, 39.7% in patients with splenectomy due to injury, and 30.8% in patients with splenectomy due to oncologic reasons (P = .032). Patients who underwent R0 gastrectomy with splenectomy due to oncologic reasons had higher 5-year mortality (the adjusted model HR, 1.26; 95% CI, 1.01–1.56) than patients who underwent spleen preservation. Conclusion: The OS was worst in patients who underwent gastrectomy with splenectomy due to oncologic reasons, highlighting the poor prognosis in patients with advanced gastric cancer. Splenectomy due to injury does not compromise the prognosis.",

keywords = "Gastrectomy, Gastric adenocarcinoma, Postoperative complication, Splenectomy",

author = "Anna Junttila and Olli Helminen and Mika Helmi{\"o} and Heikki Huhta and Aapo Jalkanen and Raija Kallio and Vesa Koivukangas and Arto Kokkola and Simo Laine and Elina Lietzen and Johanna Louhimo and Sanna Meril{\"a}inen and Pohjanen, {Vesa Matti} and Tuomo Rantanen and Ari Ristim{\"a}ki and R{\"a}s{\"a}nen, {Jari V.} and Juha Saarnio and Eero Sihvo and Vesa Toikkanen and Tuula Tyrv{\"a}inen and Antti Valtola and Kauppila, {Joonas H.}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2024",

doi = "10.1016/j.gassur.2024.10.009",

language = "English",

volume = "28",

pages = "2090--2096",

journal = "Journal of Gastrointestinal Surgery",

issn = "1091-255X",

publisher = "Springer Verlag",

number = "12",

}

Junttila, A, Helminen, O, Helmiö, M, Huhta, H, Jalkanen, A, Kallio, R, Koivukangas, V, Kokkola, A, Laine, S, Lietzen, E, Louhimo, J, Meriläinen, S, Pohjanen, VM, Rantanen, T, Ristimäki, A, Räsänen, JV, Saarnio, J, Sihvo, E, Toikkanen, V, Tyrväinen, T, Valtola, A & Kauppila, JH 2024, 'Impact of splenectomy on long-term outcomes after gastrectomy for gastric cancer: a population-based study', Journal of Gastrointestinal Surgery, vol. 28, no. 12, pp. 2090-2096. https://doi.org/10.1016/j.gassur.2024.10.009

TY - JOUR

T1 - Impact of splenectomy on long-term outcomes after gastrectomy for gastric cancer

T2 - a population-based study

AU - Junttila, Anna

AU - Helminen, Olli

AU - Helmiö, Mika

AU - Huhta, Heikki

AU - Jalkanen, Aapo

AU - Kallio, Raija

AU - Koivukangas, Vesa

AU - Kokkola, Arto

AU - Laine, Simo

AU - Lietzen, Elina

AU - Louhimo, Johanna

AU - Meriläinen, Sanna

AU - Pohjanen, Vesa Matti

AU - Rantanen, Tuomo

AU - Ristimäki, Ari

AU - Räsänen, Jari V.

AU - Saarnio, Juha

AU - Sihvo, Eero

AU - Toikkanen, Vesa

AU - Tyrväinen, Tuula

AU - Valtola, Antti

AU - Kauppila, Joonas H.

PY - 2024

Y1 - 2024

N2 - Background: No national studies comparing long-term survival after total or partial gastrectomy with splenectomy due to injury or oncologic reasons or spleen preservation exist. This study aimed to examine the 5-year overall survival (OS) of patients with gastric adenocarcinoma who underwent total or partial gastrectomy with splenectomy due to injury or oncologic reasons or spleen preservation in a population-based nationwide setting. Methods: This study included all patients undergoing total or partial gastrectomy with splenectomy or spleen preservation for gastric adenocarcinoma in Finland from 2005 to 2016, with follow-up until December 31, 2019. A total of 2196 patients with gastric cancer diagnosis and total or partial gastrectomy were identified in the registries. Of these patients, 2118 were applicable for this study. Cox proportional hazard models provided hazard ratios (HRs) with 95% CIs of 5-year OS. The results were adjusted for age, sex, year of operation, comorbidities, tumor location, pathologic stage, and neoadjuvant therapy. Results: The observed 5-year OS rates were 38.7% in patients with no or minor spleen injury, 39.7% in patients with splenectomy due to injury, and 30.8% in patients with splenectomy due to oncologic reasons (P = .032). Patients who underwent R0 gastrectomy with splenectomy due to oncologic reasons had higher 5-year mortality (the adjusted model HR, 1.26; 95% CI, 1.01–1.56) than patients who underwent spleen preservation. Conclusion: The OS was worst in patients who underwent gastrectomy with splenectomy due to oncologic reasons, highlighting the poor prognosis in patients with advanced gastric cancer. Splenectomy due to injury does not compromise the prognosis.

AB - Background: No national studies comparing long-term survival after total or partial gastrectomy with splenectomy due to injury or oncologic reasons or spleen preservation exist. This study aimed to examine the 5-year overall survival (OS) of patients with gastric adenocarcinoma who underwent total or partial gastrectomy with splenectomy due to injury or oncologic reasons or spleen preservation in a population-based nationwide setting. Methods: This study included all patients undergoing total or partial gastrectomy with splenectomy or spleen preservation for gastric adenocarcinoma in Finland from 2005 to 2016, with follow-up until December 31, 2019. A total of 2196 patients with gastric cancer diagnosis and total or partial gastrectomy were identified in the registries. Of these patients, 2118 were applicable for this study. Cox proportional hazard models provided hazard ratios (HRs) with 95% CIs of 5-year OS. The results were adjusted for age, sex, year of operation, comorbidities, tumor location, pathologic stage, and neoadjuvant therapy. Results: The observed 5-year OS rates were 38.7% in patients with no or minor spleen injury, 39.7% in patients with splenectomy due to injury, and 30.8% in patients with splenectomy due to oncologic reasons (P = .032). Patients who underwent R0 gastrectomy with splenectomy due to oncologic reasons had higher 5-year mortality (the adjusted model HR, 1.26; 95% CI, 1.01–1.56) than patients who underwent spleen preservation. Conclusion: The OS was worst in patients who underwent gastrectomy with splenectomy due to oncologic reasons, highlighting the poor prognosis in patients with advanced gastric cancer. Splenectomy due to injury does not compromise the prognosis.

KW - Gastrectomy

KW - Gastric adenocarcinoma

KW - Postoperative complication

KW - Splenectomy

U2 - 10.1016/j.gassur.2024.10.009

DO - 10.1016/j.gassur.2024.10.009

M3 - Article

AN - SCOPUS:85207030350

SN - 1091-255X

VL - 28

SP - 2090

EP - 2096

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

IS - 12

ER -

Impact of splenectomy on long-term outcomes after gastrectomy for gastric cancer: a population-based study

Abstract

Keywords

Publication forum classification

ASJC Scopus subject areas

UN SDGs

Access to Document

Fingerprint

Cite this