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Splenectomy in epithelial ovarian cancer surgery
  1. Houssein El Hajj1,
  2. Domenico Ferraioli1,
  3. Pierre Meus1,
  4. Frederic Beurrier1,
  5. Olivier Tredan2,
  6. Isabelle Ray-Coquard2,3 and
  7. Nicolas Chopin1
  1. 1 Gynecologic Oncology, Centre Leon Berard, Lyon, Rhône-Alpes, France
  2. 2 Medical Oncology Department, Centre Leon Berard, Lyon, Rhône-Alpes, France
  3. 3 Hesper lab, Université Claude Bernard Lyon 1, Villeurbanne, France
  1. Correspondence to Dr Houssein El Hajj, Gynecologic Oncology, Centre Leon Berard, Lyon, Rhône-Alpes, France; houssein-elhajj{at}


Objective Splenectomy is performed in 4–32% of cytoreductive surgeries for ovarian cancer. The objective of our study was to assess splenectomy and evaluate its impact on overall and disease-free survival.

Methods We conducted a retrospective single-center study between January 2000 and December 2016. Patients who underwent a cytoreduction for epithelial ovarian cancer, regardless of stage and surgical approach, were eligible for the study. Patients deemed not operable were excluded from the study. Patients were stratified into two groups, splenectomy or no splenectomy. A univariate analysis followed by a multivariate analysis was conducted to evaluate the postoperative complications after splenectomy and the overall and disease-free survival.

Results This cohort included 464 patients. Disease stages, peritoneal carcinomatosis scores, and the rate of radical surgery (Pomel classification) were significantly higher in the splenectomy group, p=0.04, p<0.0001, and p<0.001, respectively. However, no significant difference was found in the rate of complete cytoreduction between the two groups (p=0.26) after multivariate analysis. In univariate analysis, splenectomy was significantly associated with extensive surgical procedures. In multivariate analysis, the two more prevalent complications in the splenectomy group were the risk of abdominopelvic lymphocele (overall response (OR) =4.2; p=0.01) and blood transfusion (OR=2.4; p=0.008). The average length of hospital stay was significantly longer in the splenectomy group, 17.4 vs 14.6 days (p<0.0001). The delay in adjuvant chemotherapy was longer in the splenectomy group (p=0.001). There was no significant difference in overall and disease-free survival (p=0.09) and (p=0.79), respectively.

Conclusion Splenectomy may be considered an acceptable and safe procedure; however, with no impact on overall or disease-free survival. In addition, it is associated with longer hospital stay and longer time to chemotherapy.

  • ovarian cancer
  • spleen
  • cytoreduction surgical procedures

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors Study concepts: NC, HEH; Study design: NC, FB, PM; Data acquisition: HEH, DF; Quality control of data and algorithms: NC; Data analysis and interpretation: NC, HEH; Statistical analysis: NC; Manuscript preparation: HEH; Manuscript editing: HEH, DF, NC, FB, PM; Manuscript review: OT, IR-C; Guarantor: NC.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.