{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:18:44Z","timestamp":1786979924477,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,9,18]],"date-time":"2017-09-18T00:00:00Z","timestamp":1505692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,9,18]],"date-time":"2017-09-18T00:00:00Z","timestamp":1505692800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/501100007206","name":"Kaibara Morikazu Medical Science Promotion Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007206","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Grants-in- Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS)","award":["25670583"],"award-info":[{"award-number":["25670583"]}]},{"DOI":"10.13039\/501100007206","name":"Kaibara Morikazu Medical Science Promotion Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007206","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prognosis of hepatocellular carcinoma (HCC) with portal hypertension (PH) is very poor. Splenomegaly is considered important evidence of PH. Our aim was to clarify the prognostic value of splenic volume (SV) and the effect of splenectomy on the prognosis of HCC within the Milan criteria after curative hepatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010center retrospective study, we reviewed 160 patients with HCC that met the Milan criteria, including 138 who had undergone hepatectomy and 22 who had undergone hepatectomy and splenectomy between July 2004 and December 2010. SV was measured by three\u2010dimensional computed tomography and patients allocated to three groups (high SV \u2265300\u00a0mL; low &lt;300\u00a0mL; and splenectomy) to compare post\u2010hepatectomy survival rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multivariate analyses showed that SV is an independent prognostic factor for overall and disease\u2010free survival. The overall survival rates at 5 years in the high SV, low SV, and splenectomy groups were 39, 75, and 88%, respectively. The overall survival rate in the high SV group was significantly worse than in the low SV and splenectomy groups (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). There was no significant difference between the low SV and splenectomy groups (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.831).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High SV is an independent predictor of post\u2010hepatectomy HCC recurrence and overall survival. There is no significant difference in prognosis between low SV and splenectomy groups, even though the latter had high SV. Combined splenectomy with hepatectomy for HCC and PH may improve prognosis and be an appropriate alternative when liver transplantation cannot be performed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-017-4232-z","type":"journal-article","created":{"date-parts":[[2017,9,17]],"date-time":"2017-09-17T20:17:10Z","timestamp":1505679430000},"page":"1120-1128","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Impact of Splenic Volume and Splenectomy on Prognosis of Hepatocellular Carcinoma Within Milan Criteria After Curative Hepatectomy"],"prefix":"10.1002","volume":"42","author":[{"given":"Kazuki","family":"Takeishi","sequence":"first","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University 3\u20101\u20101 Maidashi, Higashi\u2010ku 812\u20108582 Fukuoka 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Surgery and Science, Graduate School of Medical Sciences Kyushu University 3\u20101\u20101 Maidashi, Higashi\u2010ku 812\u20108582 Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoharu","family":"Yoshizumi","sequence":"additional","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University 3\u20101\u20101 Maidashi, Higashi\u2010ku 812\u20108582 Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Shirabe","sequence":"additional","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University 3\u20101\u20101 Maidashi, Higashi\u2010ku 812\u20108582 Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Maehara","sequence":"additional","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University 3\u20101\u20101 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