Splenectomy as Part of Cytoreductive Surgery for Ovarian Carcinoma

Splenic metastases—not a frequent problem, but an underestimate location of metastases: epidemiology and course

“…A splenectomy because of metastases of a carcinoma is meaningful if there are isolated metastases or when there is a carcinoma at which the tumor reduction has to be performed before chemotherapy (Lee et al 2000;Nicklin et al 1995). In the largest published series of splenectomies because of metastases 74% of the primary tumors were ovarial carcinomas (Lee et al 2000).…”

Parenchymal splenic metastasis is an independent negative predictor of overall survival in advanced ovarian, fallopian tube, and primary peritoneal cancer

“…As described by Aletti and colleagues, a Surgical Complexity Score incorporating the number and complexity of surgical procedures performed was assigned to all patients (range, 0-18) [11]. Based on their Surgical Complexity Score, patients were then divided into low (score≤ 3), intermediate (score [4][5][6][7], and high (score 8-18) complexity scoring groups. Pathology records were evaluated for the presence of splenic involvement if splenectomy was performed.…”

“…Two studies have suggested a worse outcome for patients with splenic involvement; however, both were limited in size and did not distinguish between surface and parenchymal metastasis [4,7]. Other studies have not found an association of PSM with survival outcome, but included patients undergoing tumor debulking in both the primary and the recurrent disease setting.…”

Regional blood flow occlusion during extensive pelvic procedures for ovarian cancer: a randomized trial

“…Procedures are described to facilitate complete excision of disease at virtually all intra-abdominal locations (2,6,7,(18)(19)(20)(21)(22)(23) . However, cytoreductive operations often require multiple procedures in one setting and predictably have risk of morbidity.…”