Splenectomy in epithelial ovarian cancer surgery

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Clinical Outcomes Research

Background:

• Splenectomy is a common adjunct in cytoreductive surgeries for ovarian cancer, performed in 4-32% of cases.
• The impact of splenectomy on patient survival and postoperative recovery remains an area of clinical interest.

Purpose of the Study:

• To evaluate the role and impact of splenectomy in patients undergoing cytoreductive surgery for epithelial ovarian cancer.
• To assess the association between splenectomy and overall survival, disease-free survival, and postoperative complications.

Main Methods:

• A retrospective single-center study included 464 patients who underwent cytoreduction for epithelial ovarian cancer between 2000 and 2016.
• Patients were stratified into splenectomy and no-splenectomy groups.
• Univariate and multivariate analyses were performed to assess survival outcomes and complications.

Main Results:

• Patients undergoing splenectomy had higher disease stages and peritoneal carcinomatosis scores, but complete cytoreduction rates were similar.
• Splenectomy was associated with increased risks of abdominopelvic lymphocele and blood transfusion.
• Longer hospital stays and delayed adjuvant chemotherapy were observed in the splenectomy group.

Conclusions:

• Splenectomy in ovarian cancer cytoreductive surgery is a safe procedure.
• Splenectomy does not significantly impact overall or disease-free survival.
• The procedure is associated with increased postoperative morbidity, including longer hospital stays and delayed chemotherapy initiation.