The link between splenectomy and cancer outcomes remains unclear. Our aim was to investigate the association between splenectomy and cancer incidence, cancer progression in cancer patients.
Pooled estimates of the relative risks (RR) for cancer incidence and cancer progression were performed in a meta-analysis by random effects or ﬁxed effects models as appropriate.
Eighty-one literatures were included in our meta-analysis. We found some interesting results. First, splenectomy was associated with a signiﬁcantly increased risk of overall cancer, Non Hodgkin lymphoma, Hodgkin lymphoma, lung cancer, leukemia, breast cancer, oral and pharyngeal cancer, skin cancer, esophagus cancer, prostate cancer, bladder cancer, gastric cancer, pancreas cancer, brain and nervous system cancer. Interestingly, splenectomy for trauma increased the risk of liver cancer while splenectomy for protal hypertension decreased the risk of liver cancer. Second, splenectomy was associated with a signiﬁcantly lower 5-year overall survival (OS) for gastric cancer, colorectal cancer, esophageal and esophago‑gastric junction cancer while splenectomy was associated with a signiﬁcantly higher 5-year OS for liver cancer. Subgroup analyses based on tumor stage showed that splenectomy for gastric cancer was associated with a signiﬁcantly lower 5-year OS only for stage Ⅱ and stage Ⅲ but stage Ⅰand stage Ⅳ. Third, splenectomy increased the rate of hospital mortality of gastric cancer but had no effects on the hospital mortality of liver cancer, esophageal and esophago‑gastric junction cancer. Finally, splenectomy increased the incidence of some specific postoperative complications for cancer patients.
Splenectomy was associated with cancer incidence, cancer survival, hospital mortality, and postoperative complications. Spleen plays a two-way role in cancer incidence and cancer progression.