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A systematic review of spleen and pancreas preservation in extended lymphadenectomy for gastric cancer

Brar, Savtaj S., Seevaratnam, Rajini, Cardoso, Roberta, Law, Calvin, Helyer, Lucy and Coburn, Natalie G. (2011) A systematic review of spleen and pancreas preservation in extended lymphadenectomy for gastric cancer. Gastric Cancer, Online. ISSN 1436-3291

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Identification Number: 10.1007/s10120-011-0087-4

Abstract

Background: The overall prognosis and survival of patients with advanced gastric cancer are generally poor. Extended lymphadenectomy is recommended for patients with advanced gastric cancer; however, splenectomy and distal pancreatectomy performed with an extended lymph node dissection may be associated with increased morbidity and mortality. Method: Electronic literature searches were conducted using Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1 January 1998 to 31 December 2009. Studies on gastric carcinoma investigating extended lymphadenectomy with splenectomy and/or pancreaticosplenectomy that reported data on surgical outcomes or survival were selected. Results: Forty studies were included in this review. Decreased complication rates were demonstrated with spleen preservation in two prospective studies and three retrospective studies, and with pancreas preservation in five retrospective studies. No randomized controlled trial showed survival benefit or detriment for preservation of spleen or pancreas in extended lymphadenectomy. Improved survival was demonstrated with spleen preservation in two prospective and eight retrospective studies, and with pancreas preservation in one prospective and four retrospective studies. Conclusions: Preservation of the spleen and pancreas during extended lymphadenectomy for gastric cancer decreases complications with no clear evidence of improvement or detriment to overall survival.

Item Type: Article
Official URL: http://www.springer.com/medicine/oncology/journal/...
Additional Information: © 2011 The International Gastric Cancer Association and The Japanese Gastric Cancer Association
Divisions: Social Policy
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Sets: Departments > Social Policy
Date Deposited: 17 Oct 2011 08:51
Last Modified: 20 Jan 2020 04:26
URI: http://eprints.lse.ac.uk/id/eprint/38905

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