Our Summary

This study looked at the impact of removing the spleen (splenectomy) during a type of surgery called Cytoreductive Surgery (CRS), which is used to remove as much of a cancerous tumor as possible. The researchers wanted to know if removing the spleen during this surgery for advanced ovarian cancer had any negative effects on the patient’s survival rate.

They looked at the data from 154 patients who had this type of surgery over a period of just under 6 years. Of these, 97 had standard surgery, 57 had a more extreme version called Ultra-radical surgery, and 27 had their spleen removed.

They found that there wasn’t a significant difference in the overall survival rate between all the patients and those who had their spleen removed. They also compared the survival rate of those who had their spleen removed with those who didn’t, after accounting for various factors, and again found no significant difference.

There were three complications directly related to the removal of the spleen; one patient had an injury to the tail of their pancreas, one had a build-up of fluid in the left side of their chest, and one had a throat infection during chemotherapy.

The researchers also noted that the use of splenectomy varied widely in other studies they looked at, without any clear link to the success rate of the surgery.

The conclusion is that removing the spleen during this type of surgery for advanced ovarian cancer does not seem to be harmful to the patient’s chances of survival. However, its use seems to vary a lot and doesn’t appear to be closely linked to the success of the surgery.

FAQs

  1. Does performing a splenectomy as part of Cytoreductive Surgery for advanced ovarian cancer negatively impact patient survival?
  2. What complications are associated with splenectomy during Cytoreductive Surgery for advanced ovarian cancer?
  3. What is the variation in the utilization of splenectomy in published case series for Cytoreductive Surgery in advanced ovarian cancer?

Doctor’s Tip

A helpful tip a doctor might tell a patient about splenectomy is to be aware of the potential risks and complications associated with the procedure, such as infection, bleeding, or injury to surrounding organs. It is important to follow post-operative care instructions closely and to report any unusual symptoms or concerns to your healthcare provider. Additionally, maintaining a healthy lifestyle and staying up-to-date on vaccinations can help support your immune system after splenectomy.

Suitable For

Patients with advanced ovarian cancer who are undergoing cytoreductive surgery are typically recommended splenectomy as part of an ultra-radical procedure to increase complete cytoreduction rates. Splenectomy may also be recommended for patients with certain hematological disorders, such as hereditary spherocytosis or autoimmune hemolytic anemia, as well as for patients with traumatic injuries to the spleen.

Timeline

Before splenectomy:

  • Patient is diagnosed with advanced ovarian cancer
  • Patient undergoes evaluation to determine eligibility for cytoreductive surgery
  • Decision is made to proceed with cytoreductive surgery, including consideration of splenectomy
  • Patient undergoes pre-operative preparation and counseling
  • Surgery is performed, including splenectomy if deemed necessary

After splenectomy:

  • Patient may experience post-operative complications such as pancreatic tail injury, pleural effusion, or infection
  • Patient undergoes recovery period in the hospital
  • Patient starts chemotherapy treatment
  • Patient undergoes follow-up appointments and monitoring for recurrence
  • Patient’s survival is monitored over time, with studies showing no significant difference in overall survival between patients who underwent splenectomy and those who did not.

What to Ask Your Doctor

  1. What is the reason for recommending a splenectomy as part of my cytoreductive surgery for advanced ovarian cancer?

  2. What are the potential risks and complications associated with a splenectomy?

  3. How will a splenectomy impact my recovery time after surgery?

  4. Will I need any special vaccinations or medications after having my spleen removed?

  5. How will the absence of a spleen affect my immune system and overall health in the long term?

  6. Are there any alternative treatment options to a splenectomy that I should consider?

  7. What is the success rate of splenectomy in terms of achieving complete cytoreduction of disease?

  8. How does the utilization of splenectomy in this surgery compare to other published case series?

  9. Will I need any additional follow-up care or monitoring after having a splenectomy?

  10. Are there any lifestyle changes or precautions I should take after having a splenectomy?

Reference

Authors: Davies J, Asher V, Bali A, Abdul S, Phillips A. Journal: J Invest Surg. 2022 Jan;35(1):70-76. doi: 10.1080/08941939.2020.1824043. Epub 2020 Dec 28. PMID: 33371751