M. O. Mohamed1, D. Laan1, C. A. Thiels1, J. Bingener1 1Mayo Clinic,Surgery,Rochester, MN, USA
Introduction:
Splenectomy for hematologic malignancy is a high risk procedure, performed to improve patients’ quality of life (QOL). It is not well known which role underlying diseases play in the patient reported outcomes for these patients postoperatively.
Methods:
Patients who underwent elective splenectomy for hematological causes at our institute between the years 2009 and 2015 were identified retrospectively. Our institution routinely collects the validated LASA (Linear Analog Self-Assessment) to assess the patients’ fatigue, pain and overall QOL preoperatively (baseline) and at 1 month, 3 months, 6 months and 12 months after surgery. Demographic, operative approach, complications and one-year survival were abstracted. T-test and ANOVA were used to compare outcomes.
Results:
QOL data was available for 115 splenectomy patients including 82 patients with lymphoma, 16 patients with leukemia and 17 patients with myelofibrosis. Mean age was 62 years and 40 patients (31%) were women. Operative approach, spleen weight and complications are depicted in table 1. Thirty day mortality was zero, one year survival was 79% in the lymphoma group, 62% in the leukemia group, and 65% in patients with myelofibrosis.
Overall QOL did not markedly improve in general; only MF patients had improved QOL at one year postoperatively (0.55+3.35). Fatigue and pain showed clinically significant improvement from baseline for all groups during the follow-up period after splenectomy, more significantly for MF patients.
Increased preoperative fatigue correlated with a decreased one year survival for the leukemia group p=0.023.
Conclusion:
Splenectomy significantly improved the fatigue for lymphoma and leukemia patients over the follow up duration, overall QOL did not change markedly. More PRO data are necessary to help patients and surgeons select the appropriate timing and indication for splenectomy in hematologic malignancies.
