Splenectomy to treat splenic lesions: An analysis of 148 cases at a cancer center. Issue 8 (16th September 2013)

• Record Type: Journal Article
• Authors: Pugalenthi, Amudhan; Bradley, Ciaran; Gonen, Mithat; Do, Kinh Gian; Strong, Vivian; Jarnagin, William; Coit, Daniel; Kingham, T. Peter
• Is Part Of: Journal of surgical oncology. Volume 108:Issue 8(2013:Dec. 15)
• Page Start: 521
• Page End: 525
• Publication Date: 2013-09-16
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23433
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jso23433-sec-0001" sec-type="section"> <title>Background and Objectives</title> <p>Solid and cystic splenic masses discovered on imaging studies often pose diagnostic and management dilemmas. This study analyses a large series of splenectomies to identify preoperative factors associated with malignant splenic masses.</p> </sec> <sec id="jso23433-sec-0002" sec-type="section"> <title>Methods</title> <p>Pathology records at a single institution were reviewed for all splenectomies. Those performed as a component of a larger resection, such as staging or debulking were excluded. Demographic and clinicopathologic factors were obtained. Univariate and multivariate analyses identified factors associated with an increased risk of malignancy.</p> </sec> <sec id="jso23433-sec-0003" sec-type="section"> <title>Results</title> <p>Between 1986 and 2012, 2, 743 patients underwent a splenectomy, 148 of which were performed for lesions identified on imaging. The indications were suspicion of malignancy (120, 81%), growth over time (28, 19%), or symptoms (39, 26%). Resected splenic lesions were malignant in 93 patients (63%); the most common pathologies included ovarian cancer (n = 39), melanoma (n = 14), and colorectal cancer (n = 9). On multivariate analysis of clinicopathologic factors, a previous history of cancer was the only independent predictor of malignancy in the splenic lesion (odds ratio 6.3; 95% CI, 2.32–16.97; <italic>P</italic> = 0.001).</p> </sec> <sec id="jso23433-sec-0004" sec-type="section"> <title>Conclusion</title> <p>While the spleen is an uncommon site of metastatic disease, in patients with a history of cancer, splenic masses selected for resection are frequently malignant. <italic>J. Surg. Oncol. 2013; 108:521–525</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>