Abstract
BackgroundTo investigate changes in peripheral lymphocyte subsets after splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancers.MethodsWe enrolled 83 patients with advanced or recurrent ovarian cancer who underwent cytoreductive surgery. Twenty patients who also underwent splenectomy were assigned to the splenectomy cohort and the rest were assigned to the non-splenectomy cohort. Flow cytometry was used to measure peripheral lymphocyte subsets consisting of T cells, regulatory T cells, natural killer cells, B cells, and activation antigens before and after surgery.ResultsThere was no difference in the number and distribution of peripheral lymphocyte subsets between the two cohorts before surgery. After surgery, we observed elevated levels of T cells (CD3+, CD3+CD8+) in the splenectomy cohort compared to those in the non-splenectomy cohort, and the difference was statistically significant. CD8+CD28+ T cells had a significant decreasing tendency (P = 0.011) while CD3+/HLA-DR+ T cells showed the opposite trend (P = 0.001) in the splenectomy cohort. The proportion of Tregs (P = 0.005) and B cells (P < 0.001) including CD3−/HLA-DR+ B cells (P = 0.007) increased after surgery, and the absolute number of T cells and NK cells decreased to different extents (P < 0.001) in the non-splenectomy cohort. The post-operative percentage of CD8+CD28+ T cells was less than the pre-operative percentage (P = 0.022), which was similar to the splenectomy cohort. There was no significant difference in progression-free survival or overall survival between the groups after a median follow-up time of 41 months.ConclusionsThe changes in peripheral lymphocyte populations were different between patients with and those without splenectomy during cytoreductive surgery for ovarian cancers. T cells were increased and activated in the splenectomy cohort, whereas, B cells were increased and activated in the non-splenectomy cohort.
Highlights
To investigate changes in peripheral lymphocyte subsets after splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancers
We aimed to investigate the effect of cytoreductive surgery with or without splenectomy on the immunological status of advanced and recurrent ovarian cancer patients
Among the remaining 83 patients, 20 patients were grouped into the splenectomy cohort due to splenic metastasis, and 63 patients were grouped into the non-splenectomy cohort
Summary
To investigate changes in peripheral lymphocyte subsets after splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancers. Ovarian cancer is the most lethal gynaecologic malignancy [1]. As the spleen is one of the most important peripheral immune organs, splenectomy has been suggested to have an impact on immunological function [7]. Peripheral lymphocytes, which directly reflect a patient’s immune status, might be influenced by a variety of factors, including surgery, especially splenectomy. It is not clear whether splenectomy has a beneficial effect on immune function in advanced or recurrent ovarian cancer patients, beyond the benefit of reducing tumours
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