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Abstract
Introduction/Background*To determine the effect of splenectomy on subsequent chemotherapy treatment and prognosis in women with advanced ovarian cancer.
Methodology We performed a retrospective study comparing two cohorts of patients. Data from 60 women who underwent splenectomy during cytoreductive surgery for primary or relapse ovarian cancer were compared with 62 controls who also underwent this type of surgery without splenectomy matched for baseline and surgical characteristics including type and date of surgery at University Hospital La Fe (Spain) between November 2011 and December 2019.
Result(s)*A total of 72/459 (15,7%) women who underwent splenectomy for advanced ovarian cancer were identified. Twelve women were excluded and finally 60 cases and 62 controls were identified.
No differences were observed regarding the following variables: postoperative complications (31.7% vs. 19.4%), mean time to start adjuvant chemotherapy (48.6 vs. 42.7 days), mean time to complete chemotherapy in women who received only adjuvant treatment (104 vs. 116 days) and percentage of six-cycle chemotherapy completion (78.8% vs. 98.4%) after adjusting for a potential confounding factors. No differences were observed between groups related to cycles delayed (50% vs. 32.3%; P=0.16) and reduction in the doses of chemotherapy (23.3% vs. 22.6; P=0,61); unlike the differences found according to cycles cancelled (30% vs. 11.3%; P=0.037). Two women died in the splenectomy group (3.3%). The mean follow-up time was 30.4 months. There were no differences in progression free-survival (long-rank=0.069) or overall survival (long-rank=0.47) between the groups.
Conclusion*Splenectomy in the course of debulking surgery for ovarian cancer does not seem to be associated with a higher rate of postoperative complications. Additionally, splenectomy does not have a deleterious influence before or during chemotherapy administration or a negative impact on oncological outcome.