Partial splenectomy after preoperative embolization in a patient with metastatic melanoma – A case report

Hauge, Tobias; Dorenberg, Eric; Goscinski, Mariusz Adam

doi:10.1016/j.ijscr.2022.106837

Cited by 1 publication

(1 citation statement)

References 15 publications

(16 reference statements)

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“…While not the particular subject of this paper, there are reports of partial splenectomy being performed for SM [105][106][107][108], and thus, this may be a theme for future research. Partial splenectomy, including the laparoscopic approach, has been demonstrated as safe in experienced surgeon hands, with low morbidity rates, being proposed as an alternative to total splenectomy for a specific pathology to overcome potential complications of asplenia; a malignant pathology is, however, a very rare indication for partial splenectomy (1.5%) [106,107,109,110].…”

Section: Discussionmentioning

confidence: 99%

A Glimpse into the Role and Effectiveness of Splenectomy for Isolated Metachronous Spleen Metastasis of Colorectal Cancer Origin: Long-Term Survivals Can Be Achieved

Tivadar,

Dumitrascu,

Vasilescu

2024

JCM

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Background: Many papers exploring the role of resectioning metastases in colorectal cancer (CRC) have focused mainly on liver and lung sites, showing improved survival compared with non-resectional therapies. However, data about exceptional metastatic sites such as splenic metastases (SMs) are scarce. This paper aims to assess the role and effectiveness of splenectomy in the case of isolated metachronous SM of CRC origin. Methods: The patients’ data were extracted after a comprehensive literature search through public databases for articles reporting patients with splenectomies for isolated metachronous SM of CRC origin. Potential predictors of survival were explored, along with demographic, diagnostic, pathology, and treatment data for each patient. Results: A total of 83 patients with splenectomies for isolated metachronous SM of CRC origin were identified. The primary CRC was at an advanced stage (Duke’s C—70.3%) and on the left colon (45.5%) for most patients, while the median interval between CRC resection and SM was 24 months. The median overall survival after splenectomy was 84 months, and patients younger than 62 years presented statistically significantly worse overall survival rates than those ≥62 years old (p = 0.011). There was no significant impact on the long-term outcomes for factors including primary tumor location or adjuvant chemotherapy (p values ≥ 0.070, ns). Laparoscopic splenectomy was increasingly used in the last 20 years from 2002 (33.3% vs. 0%, p < 0.001). Conclusions: Splenectomy is the optimal treatment for patients with isolated metachronous SM of CRC, with the laparoscopic approach being increasingly used and having the potential to become a standard of care. Encouraging long-term survival rates were reported in the context of a multidisciplinary approach. Younger ages are associated with worse survival. Perioperative chemotherapy in the context of a patient diagnosed with SM of CRC origin appears to be a reasonable option, although the present study failed to show any significant impact on long-term survival.

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