Cancer Research and Treatment

Original Articles

Clinicopathologic Characteristics, Surgical Treatment and Outcomes for Splenic Flexure Colon Cancer: Chan Wook Kim, Ui Sup Shin, Chang Sik Yu, Jin Cheon Kim; Cancer Res Treat. 2010;42(2):69-76. Published online June 30, 2010; DOI: https://doi.org/10.4143/crt.2010.42.2.69

Purpose

This current study examined the clinicopathologic characteristics of patients with splenic flexure (SF) colon cancer and the association with the surgical outcomes to find the optimal procedure to treat this malady.

Materials and Methods

A total of 167 operated patients with SF colon cancer were consecutively recruited between 1993 and 2003. The clinicopathological, operative and survival data was reviewed and analyzed.

Results

For the SF colon cancer patients, the proportion of males was higher than that for the right-sided colon patients or the sigmoid-descending junction & sigmoid (SD & S) colon patients (p≤0.05, respectively) and the age at the time of diagnosis was younger (p≤0.05). Obstruction was more frequent in the patients with SF colon cancer than that for the patients with colon cancer at other sites (p≤0.001). The incidence of mucinous adenocarcinoma for the SF patients was similar to that for the patients with right-sided colon cancer, but it was higher than that for the patients with SD & S colon cancer (11.4% vs. 6.5%, p=0.248 or 2.5%, respectively, p=0.001). Disease-free and overall survival did not differ between the patients who underwent a left hemicolectomy and extended surgery such as combined splenectomy or subtotal colectomy. Multivariate analysis showed that old age (≥60 years) and a N1-2 and M1 status were the independent risk factors for overall survival.

Conclusion

The SF colon cancers exhibited exclusively different characteristics as compared to colon cancers at other site colon cancers. It appears that left hemicolectomy was generally sufficient for a satisfactory oncological outcome, obviating concurrent splenectomy.

Citations

Citations to this article as recorded by

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Annals of Surgical Treatment and Research.2021; 101(5): 274. CrossRef
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Techniques in Coloproctology.2020; 24(2): 191. CrossRef
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Q. Chenevas-Paule, B. Trilling, P. Y. Sage, E. Girard, J. L. Faucheron
Techniques in Coloproctology.2020; 24(1): 41. CrossRef
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Clinical–Pathologic Characteristics and Long-term Outcomes of Left Flexure Colonic Cancer: A Retrospective Analysis of an International Multicenter Cohort
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Short- and long-term outcomes after transverse versus extended colectomy for transverse colon cancer. A systematic review and meta-analysis
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Gastrosplenic Fistula Complicated in a Patient with Non- Hodgkin's Lymphoma: Seong Eun Yang, Jong Youl Jin, Chi Won Song, Ji Chan Park, Jee In Lee, Wook Kim, Jeana Kim, Hae Giu Lee; Cancer Res Treat. 2002;34(2):153-156. Published online April 30, 2002; DOI: https://doi.org/10.4143/crt.2002.34.2.153

Abstract PDF

Reported cases of gastrosplenic fistulas are extremely rare in the literature. Malignancy is the primary cause in 50% of patients, followed by perforated peptic ulcer (40%). Fistulas can cause spleen rupture and potential bleeding that threaten the life of the patient. Lymphoma is the most common cause of malignancy complicated with gastrosplenic fistula. Most gastrosplenic fistulae caused by lymphoma eventually close following chemotherapy, although splenectomy should be performed to avoid further complications. We experienced a case of non-Hodgkin's lymphoma complicated with gastrosplenic fistula in a 21 year-old man. He was admitted to our hospital because of LUQ mass. On the abdominal CT, a splenic mass with central necrosis and gas was discovered. The biopsy specimen of the stomach and spleen displayed diffuse, large B cell type non-Hodgkin's lymphoma. After one cycle of CHOP chemotherapy, the LUQ mass was markedly regressed although the gastrosplenic fistula was still present on the follow-up CT. The fistula was treated by splenectomy and a partial resection of gastric fundus. Follow-up chemotherapy was continued after surgery.

Citations

Citations to this article as recorded by

SPONTANEOUS GASTROSPLENIC FISTULA: AN UNUSUAL PRESENTATION OF DIFFUSE LARGE B CELL LYMPHOMA
Hale Bülbül, Kader Irak, Selin Berk, Yusuf Ulusoy, Mesut Ayer
Gastroenterology Nursing.2022; 45(1): 63. CrossRef
Gastro-Splenic Fistula Related to Large B Cell Lymphoma
Diana Triantafyllopoulou, Ioannis Gkikas, Jagdish Adiyodi, Iain Crossingham, Shofiq Al-Islam, Muhammad Shahbaz Alam, Neil Sahasrabudhe, Ambareen Kausar, Ali Bin Ayub, Hazel Cowburn, Lisa Fox, Maqsood Punekar, Marian Macheta, Reuben Tooze
Reports.2020; 3(2): 17. CrossRef
Hand-assisted laparoscopic approach for the treatment of gastrosplenic fistula: A case report and review of the literature
Virginia Gallo, Luigi Pugliese, Francesco S. Latteri, Andrea Peri
Laparoscopic, Endoscopic and Robotic Surgery.2020; 3(4): 120. CrossRef
Successful Treatment of Gastrosplenic Fistula Arising from Diffuse Large B-Cell Lymphoma with Chemotherapy: Two Case Reports
Makoto Saito, Kencho Miyashita, Yosuke Miura, Shinpei Harada, Reiki Ogasawara, Koh Izumiyama, Akio Mori, Masanori Tanaka, Masanobu Morioka, Takeshi Kondo
Case Reports in Oncology.2019; 12(2): 376. CrossRef
Gastrosplenic fistula occurring in lymphoma patients: Systematic review with a new case of extranodal NK/T-cell lymphoma
Dong Hyeok Kang, Jimi Huh, Jong Hwa Lee, Yoong Ki Jeong, Hee Jeong Cha
World Journal of Gastroenterology.2017; 23(35): 6491. CrossRef
Lymphoma Causing Gastrosplenic Fistula Revealed by FDG PET/CT
Trent P. Wang, Mohan Doss, Jeffrey L. Tokar, Sanjay Reddy, Stefan K. Barta, Jian Q. Yu
Clinical Nuclear Medicine.2017; 42(11): 890. CrossRef
Gastrosplenic Fistula From Hodgkin's Lymphoma
Carolyn D. Seib, Flavio G. Rocha, Dick G. Hwang, Brent T. Shoji
Journal of Clinical Oncology.2009; 27(20): e15. CrossRef

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Role of Distal Pancreatectomy on the Prognosis of Gastric Cancer Patients Undergoing Total Gastrectomy: Sang Uk Han, Yong Kwan Cho, Bong Wan Kim, Tae Hee Kim, Myung Wook Kim; J Korean Cancer Assoc. 1999;31(5):955-963.

Abstract PDF: PURPOSE
A distal pancreatectomy was often simultaneously performed with splenectomy and total gastrectomy in the treatment of gastric carcinoma for complete removal of lymph nodes around the splenic artery. However, pancreatic juice leakage, subphrenic abscess, and postoperative diabetes were common complications in patients treated by pancreas resection. We performed a retrospective analysis to evaluate the role of distal pancreatectomy on the prognosis of gastric cancer patients.
MATERIALS AND METHODS
The effect of distal pancreatectomy on survival was studied by examination of the records of 120 patients who underwent splenectomy and total gastrectomy for gastric carcinoma with serosal invasion. Of these, 75 underwent pancreas preserving splenectomy and 45 underwent pancreaticosplenectomy. Prognostic factors and postoperative complications were evaluated according to the operation types.
RESULTS
The addition of distal pancreatectomy to splenectomy with total gastrectomy for patients with gastric cancer was not associated with severe complications. And patients underwent pancreaticosplenectomy showed similar survival as those underwent pancreas preserving splenectomy.
CONCLUSION
Distal pancreatectomy for the gastric cancer patients with suspected metastatic lymph nodes around the splenic artery could be recommended for the purpose of radical lymph node dissection.

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Clinical Trial

Effects of Combined Splenectomy with Total Gastrectomy on the Prognosis in Gastric Cancer: Young Jae Mok, Seung Joo Kim, Gil Soo Son, Min Young Cho, Young Chul Kim, Sae Min Kim; J Korean Cancer Assoc. 1997;29(4):632-639.

Abstract PDF: PURPOSE
This study was carried out to evaluate the impact of combined splenectomy with total gastrectomy on survival and postoperative morbidity in advanced gastric cancer. PATIENTS AND METHODS: We performed a retrospective analysis of 193 patients who underwent curative resection among 289 patients with total gastrectomy during the period of Sep. 1983 through Dec. 1995 at the Department of Surgery, Korea University Hospital.
RESULTS
Out of 11 clinicopathologic factors, 5 were associated with splenectomy through univariate analysis. The incidence of splenectomy increased when the patients with advanced gastric cancer had Borrmann type III, Gross T3 & T4 stage, greater than 4 cm of tumor size, Serosal invasion, or UICC stage IIIb, IV (p<0.05). Postoperative complication occurred more commonly in splenectomy group than in non-splenectomy group (20.2% vs 16.9%). The 5-year survival rate of Stage II was lower in splenectomy group than in non-splenectomy group (63.5% vs 83.5%) but that of Stage III was higher in splenectomy group than in non-splenectomy group (22.8% vs 17.3%), there was no significant difference between the survival rates across different stages.
CONCLUSION
We could not find any beneficial effect of splenectomy in gastric cancer patients who underwent curative total gastrectomy in this retrospective analysis. There was no clinical evidence to support splenectomy as a general policy in patients with total gastrectomy. We conclude that the randomized prospective clinical trials using more precise criteria for the indication of splenectomy are needed in order to assess the beneficial effect of splenectomy.

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Original Article

The Prognostic Effects of Spleen Preservation in The Radical Total Gastrcomy: Hee Duck Kim, Chung Han Lee, Kyung Hyun Choi, Seung Do Lee, Jae Kwan Suh; J Korean Cancer Assoc. 1994;26(2):198-208.

Abstract PDF: In Gastric Cancer Surgery, an extended radical operation is common procedure, and in cases of total gastrectomy, there is a tendency to perform splenectomy at the same time. However, regarding to the prophylactic splenectamy for clearing of spleen hilar nodes the prognostic ef- fectivity is controversiaL We studied the value of spleen preservation in total gastrectomy for gastric cancer by survival rate, according to tumor stage and tumor location and by inflammatory complications. And another study was done on cellular immunity of total gastrectomy patients by T-cell subset(T3T4T5 & T4T8 Ratio) and Natural Killer cell activity changes(preoperative day and postoperative 2 months) with or without combined splenectomy. In five year survival rate of stage I and II groups, spleen preserving group(78.7%) has better prognosis than splenectomized group(70.4%) and in stage III and IV groups, 5 year survival rate of nonsplenectomized cases(30%) showed higher than that of splenectomized cases(17%). Five year survival rate of nonsplenectomized, proximal gastric cancer group(57.5%) showed significantly better than that of splenectomized group(30%). Postoperative T4/T8, ratio and NK cell activity were markedly decreased compared to preoperative ratio in the splenectomized group than the non-splenectomized and control groups. Consequently spleen preserving group group had better prognosis than splenectomized group in total gastrectomy, which may be attributable in part to reduction of cellular immunity caused by splenectomy. It seems to be desirable that accordingly prophylactic splenectomy in gastric cancer surgery should be reconsidered.

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