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Splenectomy as Part of Primary Cytoreductive Surgery for Advanced Ovarian Cancer: A Retrospective Cohort Study

Zapardiel, Ignacio MD, PhD; Peiretti, Michele MD, PhD; Zanagnolo, Vanna MD; Biffi, Roberto MD; Bocciolone, Luca MD; Landoni, Fabio MD; Aletti, Giovanni MD; Colombo, Nicoletta PhD; Maggioni, Angelo MD

International Journal of Gynecological Cancer: July 2012 - Volume 22 - Issue 6 - p 968–973
doi: 10.1097/IGC.0b013e3182571479
Ovarian Cancer

Background: The aim of surgical approach in advanced ovarian cancer should be the complete removal of all visible disease. Our purpose was to compare perioperative features and postoperative complications, and secondarily oncological outcomes, between patients who underwent splenectomy and those who did not at the time of surgery.

Materials and Methods: Thirty-three subjects underwent splenectomy, and we selected 99 controls with similar surgical characteristics but who did not undergo splenectomy. Data collected included perioperative details and follow-up data.

Results: Longer operating time (33 minutes longer; P = 0.02), larger estimated blood loss (812 mL more; P = 0.03), higher rate of intraoperative blood transfusions (78.8% vs 42.4%; P < 0.01), and intensive care unit stay (1.4 vs 0.5 days; P < 0.01) as well as higher pneumonia rate (2% vs 0%; P = 0.01) were observed in the splenectomy group. Disease-free and overall survival rates were 30.3% and 66.6%, respectively, in the splenectomy group, and 33.3% and 59.6%, respectively, in the control group.

Conclusions: Splenectomy at the time of primary cytoreductive surgery for advanced ovarian cancer may contribute to achieve complete cytoreduction with low perioperative complication rate. This procedure seems to be an acceptable and rational intervention to increase the survival rates of those patients.

Gynecologic Oncology Department, European Institute of Oncology, Milan, Italy.

Address correspondence and reprint requests to Ignacio Zapardiel MD, PhD, Gynecologic Oncology Department, European Institute of Oncology, Via Ripamonti 435. Milan, Italy. E-mail: ignaciozapardiel@hotmail.com.

The authors declare that there are no conflicts of interest.

Received October 31, 2011

Accepted March 23, 2012

Copyright © 2012 by IGCS and ESGO