Skip to main content
Log in

Does concurrent splenectomy at colorectal cancer resection influence survival?

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Twenty-one patients had a concurrent splenectomy with resection of colorectal cancer between 1970 and 1988. These were matched individually with disease control patients based on age, sex, site of tumor, Dukes stage, tumor differentiation, and date of the operation. Significantly more patients in the splenectomy group (n=11) developed postoperative infective complications than in the control group (n=4) (McNemar test:P=0.03). Five-year overall actuarial survival was 45 percent in the former group and 59 percent in the latter (log rank test: chi-squared=1.07;P=0.24). Similarly, five-year disease-free survival in 17 patients with Dukes B and C cancers who had curative resections did not differ between the groups (log rank test: chi-squared=0.08;P> 0.25). These results suggest that splenectomy with resection of colorectal cancer increases the risk of postoperative sepsis and does not influence long-term survival. The infrequency of concurrent splenectomy at resection of colorectal cancer may not overcome Type II error.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fryd DS, Sutherland DE, Simmons RL, Fergusson RM, Kjellstrand CM, Najarian JS. Results of a prospective randomized study on the effect of splenectomy versus no splenectomy in renal transplant patients. Transplant Proc 1981;13:48–56.

    PubMed  CAS  Google Scholar 

  2. Meyer JD, Argyris BF, Meyer JA. Splenectomy, suppressor cell activity, and survival in tumour bearing rats. J Surg Res 1980;29:527–32.

    Article  PubMed  CAS  Google Scholar 

  3. Hull CC, Galloway P, Gordon N, Gerson SL, Hawkins N, Stallato TA. Splenectomy and induction of murine colon cancer. Arch Surg 1988;123:462–4.

    PubMed  CAS  Google Scholar 

  4. Sato M, Michaelides MC, Wallack MK. Effect of splenectomy on the growth of murine colon tumours. J Surg Oncol 1983;22:73–6.

    PubMed  CAS  Google Scholar 

  5. Davis CJ, Ilstrup DM, Pemberton JH. Influence of splenectomy on survival rate of patients with colorectal cancer. Am J Surg 1988;155:173–9.

    PubMed  CAS  Google Scholar 

  6. Wolters U, Keller HW, Muller JM, Pichlmaeir H. Effect of accidental splenectomy on long term outcome in colorectal tumour surgery. Chirurg 1991; 62:47–50.

    CAS  PubMed  Google Scholar 

  7. Devlin HB, Evans DS, Birkhead JS. The incidence and morbidity of accidental injury to the spleen occurring during abdominal surgery. Br J Surg 1969;56:446–8.

    PubMed  CAS  Google Scholar 

  8. Klaue P, Eckert P, Kern E. Incidental splenectomy: early and late postoperative complications. Am J Surg 1979;138:296–300.

    Article  PubMed  CAS  Google Scholar 

  9. Schwartz PE, Sterioff S, Mucha P, Melton LJ, Offord KP. Post splenectomy sepsis and mortality in adults. JAMA 1982;248:2279–83.

    Article  PubMed  CAS  Google Scholar 

  10. Langevin JM, Rothenberger DA, Goldberg SM. Accidental splenic injury during surgical treatment of the colon and rectum. Surg Gynecol Obstet 1984;159:139–44.

    PubMed  CAS  Google Scholar 

  11. Ruckdeschel JC, Codish SD, Stranahan A, McKneally MF. Postoperative empyema improves survival in lung cancer. N Engl J Med 1972;287:1013–7.

    Article  PubMed  CAS  Google Scholar 

  12. Turnbull RB Jr, Kyle K, Watson FR, Spratt J. Cancer of the colon: the influence of no touch isolation technique on survival rates. Ann Surg 1967;166:420–7.

    Article  PubMed  Google Scholar 

  13. Dukes CE. The classification of cancer of the rectum. J Pathol 1932;35:323–32.

    Article  Google Scholar 

  14. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457–81.

    Google Scholar 

  15. Peto R, Peto J. Asymptotically efficient rank invariant procedures. J R Stat Soc 1972 135:185–207.

    Article  Google Scholar 

  16. Llende M, Santiago-Delphin EA, Lavergne J. Immunobiological consequences of splenectomy: a review. J Surg Res 1986;40:85–94.

    Article  PubMed  CAS  Google Scholar 

  17. Orita K, Konaga E, Okada T, Kunisada K, Yumura M, Tanaka S. Effect of splenectomy in tumour bearing mice and gastric cancer patients. Jpn J Cancer Res 1977;68:731–6.

    CAS  Google Scholar 

  18. Suehiro S, Nagasue N, Ogawa Y, Sasaki Y, Hirose S, Yukaya H. The negative effect of splenectomy on the prognosis of gastric cancer. Am J Surg 1984;148:645–8.

    Article  PubMed  CAS  Google Scholar 

  19. Yoshino K, Haruyama K, Nakamura S,et al. Evaluation of splenectomy for gastric carcinoma. Jpn J Gastroenterol Surg 1979;12:944–9.

    Google Scholar 

  20. Brady MS, Rogatko A, Dent LL, Shiu MH. Effect of splenectomy on morbidity and survival following curative gastrectomy for carcinoma. Arch Surg 1991;126:359–64.

    PubMed  CAS  Google Scholar 

  21. Sonnendecker EW, Guidozzi F, Margoulis KA. Splenectomy during maximal cytoreductive surgery for epithelial ovarian cancer. Gynecol Oncol 1989;35:301–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Varty, P.P., Linehan, I.P. & Boulos, P.B. Does concurrent splenectomy at colorectal cancer resection influence survival?. Dis Colon Rectum 36, 602–606 (1993). https://doi.org/10.1007/BF02049869

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02049869

Key words

Navigation