Distal pancreatectomy with splenectomy for the management of splenic hilum metastasis in cytoreductive surgery of epithelial ovarian cancer

Xiang, Libing; Tu, Yunxia; He, Tiancong; Li, Ziting; Wu, Xiaohua; Yang, Huijuan

doi:10.3802/jgo.2016.27.e62

Cited by 18 publications

(17 citation statements)

References 16 publications

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“…However, splenectomy as a part of cytoreductive surgery in EOC demonstrating splenic metastasis is rarely seen in clinical practice. 7 , 8 There are two reasons for this phenomenon. First, many studies suggest that the splenic capsule could act as a shield and its contractile properties might also be involved by squeezing the tumor cells out.…”

Section: Discussionmentioning

confidence: 99%

Splenectomy during cytoreductive surgery in epithelial ovarian cancer

Sun

Cao

et al. 2018

CMAR

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BackgroundThe aim of the study was to analyze the underlying causes and application of splenectomy in patients with epithelial ovarian cancer (EOC) and assess its effect on the surgical satisfaction and prognosis of these patients.Materials and methodsClinical data of patients with ovarian epithelial cancer treated with cytoreductive surgery were collected from 2000 to 2015 at Peking Union Medical College Hospital.ResultsA total of 2,882 patients underwent ovarian cancer cytoreductive surgery at Peking Union Medical College Hospital between 2000 and 2015, of whom 38 (1.3%) also underwent spleen resections. Of these 38 patients, one underwent splenectomy due to intraoperative trauma, whereas the remaining 37 patients underwent splenectomy due to splenic metastasis. Among these 37 patients, 27 underwent resection due to direct tumor spread in the spleen and 10 underwent resection due to hematogenous metastasis. For subsequent first-line chemotherapy, 22 patients were platinum sensitive and 15 were platinum resistant. Overall median survival and the postsplenectomy median survival time were 106 and 75 months, respectively. The overall median survival in secondary cytoreduction was 101 months compared with 20.3–56 months in literature reviews. Univariate analysis revealed that platinum resistance to first-line chemotherapy, suboptimal surgery, and hematogenous metastasis influenced survival. Chemosensitivity and residual disease were identified as independent risk factors by multivariate analysis. We also report a literature review concerning the efficacy and safety of splenectomy during cytoreductive surgery in EOC.ConclusionApproximately 1.3% of patients with EOC underwent spleen resection during initial cytoreductive surgery and more often during recytoreductive surgery. Tumor involvement was the most common indication for splenectomy, and rare patients underwent splenectomy due to intraoperative trauma. Most patients achieved optimal surgery, and thus their overall survival and postsplenectomy survival rates were longer. The prognosis of patients was closely related to chemosensitivity and presence of residual tumors. Splenectomy should be attempted in all patients with splenic involvement in whom optimal cytoreductive surgery was achievable, no matter in primary or secondary cytoreduction.

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Section: Discussionmentioning

confidence: 99%

Splenectomy during cytoreductive surgery in epithelial ovarian cancer

Sun

Cao

et al. 2018

CMAR

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“…However, it appears that there is significant morbidity of postoperative patients, but it was found that the vast majority of complications could be treated conservatively, with no need for surgical reintervention [39].…”

Section: • Interval Citoreductionmentioning

confidence: 99%

Importance of Surgical Treatment in Ovarian Neoplasm

Dinca¹,

Dinca²,

Constantinoiu³

et al. 2020

Rev. Chim.

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“…It is well accepted that optimal cytoreduction improves survival in ovarian cancer patients [3,4] . In some circumstances, removal of the spleen as part of upper abdominal surgery is required to achieve complete resection [5,6] .…”

Section: Introductionmentioning

confidence: 99%

Changes of Peripheral Lymphocyte Populations in Patients with Advanced/Recurrent Ovarian Cancer Undergoing Splenectomy During Cytoreductive Surgery

Chen

et al. 2020

Preprint

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Background: To investigate the change of peripheral lymphocyte subsets after splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancersMethods: We enrolled 83 patients with advanced or recurrent ovarian cancer who underwent cytoreductive surgery between 09/2016 and 01/2019. Twenty patients who also underwent splenectomy were assigned to the splenectomy cohort and the rest to the non-splenectomy cohort. Flow cytometry was used to measure the peripheral lymphocyte subsets consisting of T cells, regulatory T cells, natural killer cells, B cells, and activation antigens before and after surgery.Results: There was not any difference in the number and distribution of peripheral lymphocyte subsets between the two cohorts before surgery. We observed elevated levels of T cells (CD3+, CD3+CD8+) in the splenectomy cohort compared to those in the non-splenectomy cohort after surgery, which achieved statistical significance. The post-operative CD4/CD8 ratio was lower in the splenectomy cohort than in the non-splenectomy cohort (P = 0.048). Regarding the changes of lymphocyte subsets after surgery, CD8+CD28+ T cells had a significant decreasing tendency (P = 0.011) while CD3+/HLA-DR+ T cells were the opposite (P = 0.001) in the splenectomy cohort. In the non-splenectomy cohort, the proportion of Tregs (P = 0.005) and B cells (P < 0.001) including CD3−/HLA-DR+ B cells (P = 0.007) increased after surgery, and the absolute number of T cells and NK cells decreased to different extents (P < 0.001). The post-operative percentage of CD8+CD28+ T cells was less than the pre-operative one (P = 0.022), which was similar to the splenectomy cohort.Conclusions: The changes of peripheral lymphocyte populations were different between patients with splenectomy and without splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancers. T cells were increased and activated in splenectomy cohort, whereas, B cells were increased and activated in non-splenectomy.

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Distal pancreatectomy with splenectomy for the management of splenic hilum metastasis in cytoreductive surgery of epithelial ovarian cancer

Cited by 18 publications

References 16 publications

Splenectomy during cytoreductive surgery in epithelial ovarian cancer

Splenectomy during cytoreductive surgery in epithelial ovarian cancer

Importance of Surgical Treatment in Ovarian Neoplasm

Changes of Peripheral Lymphocyte Populations in Patients with Advanced/Recurrent Ovarian Cancer Undergoing Splenectomy During Cytoreductive Surgery

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