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Splenectomy ameliorates hematologic toxicity of hyperthermic intraperitoneal chemotherapy
Robert D Becher1, Perry Shen, John H Stewart
1Surgical Oncology Service, Department of General Surgery, Wake Forest University School of Medicine, Winston-Salem, NC.
Background:
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is a promising modality for peritoneal carcinomatosis. Splenectomy is frequently required, however effect upon hematotoxicity is unknown.
Methods:
195 patients undergoing the procedure were evaluated and granulocyte colony stimulating factor administered for white blood cell counts <4.0.
Results:
52% of 195 underwent splenectomy; average white blood cell and platelet nadirs were 6.1,172. Non-splenectomy patients averaged white blood cell nadir 4.6, platelet nadir 164.1. Granulocyte colony stimulating factor administered in 29% of splenectomy, 43% of non-splenectomy (P=0.043).
Conclusion:
Splenectomy ameliorates hematotoxicity of hyperthermic intraperitoneal chemotherapy and significantly reduces post-operative granulocyte colony stimulating factor requirements.
