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Splenectomy for splenic metastases: a changing clinical spectrum
S S Lee1, L Morgenstern, E H Phillips
1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
The American Surgeon
|September 19, 2000
Summary
Splenic metastases are rare, but splenectomy use increased significantly from 1990-1999, mainly for ovarian cancer. This study details the largest series of splenectomies for splenic metastases.
Area of Science:
- Oncology
- Surgical Oncology
- Pathology
Background:
- Splenic metastases from solid tumors are uncommon, with limited case reports predating 1987.
- The spleen is an unusual site for metastatic disease, often presenting late in cancer progression.
Purpose of the Study:
- To analyze trends in splenectomy for splenic metastases between 1990 and 1999.
- To report the largest series of splenectomies for splenic metastases and discuss management strategies.
Main Methods:
- Retrospective chart review of 31 patients with splenic metastases undergoing splenectomy.
- Analysis of metastasis location, timing relative to primary tumor, and surgical indications.
Main Results:
- A statistically significant increase in splenectomies for metastatic tumors was observed (Spearman rank correlation=0.86, P<0.05).
- Ovarian neoplasms accounted for the majority of splenectomies (23/31).
- In 26% of cases (8/31), the spleen was the sole site of metastatic disease.
Conclusions:
- The increased use of splenectomy for splenic metastases, particularly in ovarian cancer, may reflect expanded treatment options or improved diagnostic imaging.
- This series highlights the importance of considering splenectomy in select cases of splenic metastases, including rare instances like isolated colorectal cancer metastasis.