TY - JOUR
T1 - Splenectomy to treat splenic lesions
T2 - An analysis of 148 cases at a cancer center
AU - Pugalenthi, Amudhan
AU - Bradley, Ciaran
AU - Gonen, Mithat
AU - Do, Kinh Gian
AU - Strong, Vivian
AU - Jarnagin, William
AU - Coit, Daniel
AU - Kingham, T. Peter
PY - 2013/12
Y1 - 2013/12
N2 - Background and Objectives 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. Methods 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. Results 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; P = 0.001). Conclusion 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. J. Surg. Oncol. 2013; 108:521-525.
AB - Background and Objectives 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. Methods 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. Results 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; P = 0.001). Conclusion 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. J. Surg. Oncol. 2013; 108:521-525.
KW - metastasis
KW - splenectomy
KW - splenic lesion
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U2 - 10.1002/jso.23433
DO - 10.1002/jso.23433
M3 - Article
C2 - 24105804
AN - SCOPUS:84887463415
SN - 0022-4790
VL - 108
SP - 521
EP - 525
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 8
ER -