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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Splenic Enlargement During Neoadjuvant Chemotherapy for Gastric Cancer: Treatment-Related Phenomenon or Prognostic Biomarker?

  • Ezgi Altınsoy1
  • Veysel Cem Özcan2
  • Abdurrahman Başpınar3
  • Başak Gülpınar4
  • Selim Tamam5
  • Serdar Çulcu5
  • Salim Demirci5
5 affiliations
  1. 1Surgical Oncology Department, Van Training and Research Hospital, Süphan Mahallesi Hava Yolu Kavşağı 1. Kilometre, Edremit/Van 65300, Türkiye
  2. 2Surgical Oncology Department, Antalya City Hospital, Göçerler Mahallesi 5379. Sokak, Kepez/Antalya 07080, Türkiye
  3. 3Surgical Oncology Department, Ordu University Training and Research Hospital, Bucak Mahallesi Nefsi Bucak Caddesi, Altınordu/Ordu 52200, Türkiye
  4. 4Radiology Department, Faculty of Medicine, Ankara University, Balkiraz Mahallesi Tıp Fakültesi Caddesi, Mamak/Ankara 06620, Türkiye
  5. 5Surgical Oncology Department, Faculty of Medicine, Ankara University, Balkiraz Mahallesi Tıp Fakültesi Caddesi, Mamak/Ankara 06620, Türkiye
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Abstract

Introduction: Spleen volume (SV) may increase during systemic chemotherapy, potentially reflecting treatment-related hepatic, hematological, and immune alterations. However, the clinical significance of SV changes during neoadjuvant chemotherapy (NAC) for gastric cancer remains unclear. This study evaluated SV changes during NAC and their associations with radiological response and overall survival (OS). Methods: This retrospective cohort study included 111 patients with gastric adenocarcinoma who received NAC followed by curative-intent gastrectomy. SV was measured on computed tomography before and after NAC using semiautomated volumetric segmentation. Relative SV change (ΔSV%) was calculated. Radiological response was assessed according to RECIST 1.1. Associations of ΔSV% with objective response and OS were evaluated using logistic and Cox regression analyses, respectively. Results: Mean SV increased significantly from 250.59 ± 98.11 to 335.40 ± 126.81 cm3 (p < 0.001), with a mean ΔSV% of 34.53 ± 15.72%. SV increased in 108 patients (97.3%). Objective response was observed in 56 patients (50.5%). ΔSV% did not differ between responders and nonresponders (34.05 ± 15.66% vs. 35.03 ± 15.90%; p = 0.730) and was not associated with objective response after multivariable adjustment (OR per 10% increase, 0.932; 95% CI, 0.715–1.207; p = 0.578). ΔSV% was also not associated with OS (adjusted HR, 1.031; 95% CI, 0.859–1.236; p = 0.745). Conclusions: SV increased markedly in nearly all patients during NAC for gastric cancer. However, the magnitude of this increase was not associated with radiological response or OS, suggesting that splenic enlargement during NAC may represent a treatment-associated phenomenon rather than a marker of antitumor efficacy or prognosis.

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Cite

BibTeXRIS
BibTeX
@article{altınsoy2026splenic,
  title = {{Splenic Enlargement During Neoadjuvant Chemotherapy for Gastric Cancer: Treatment-Related Phenomenon or Prognostic Biomarker?}},
  author = {Ezgi Altınsoy and Veysel Cem Özcan and Abdurrahman Başpınar and Başak Gülpınar and Selim Tamam and Serdar Çulcu and Salim Demirci},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218303},
  url = {https://www.mdpi.com/2077-0383/15/21/8303},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Splenic Enlargement During Neoadjuvant Chemotherapy for Gastric Cancer: Treatment-Related Phenomenon or Prognostic Biomarker?
AU  - Ezgi Altınsoy
AU  - Veysel Cem Özcan
AU  - Abdurrahman Başpınar
AU  - Başak Gülpınar
AU  - Selim Tamam
AU  - Serdar Çulcu
AU  - Salim Demirci
PY  - 2026
DA  - 2026/10/25
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218303
UR  - https://www.mdpi.com/2077-0383/15/21/8303
AB  - Introduction: Spleen volume (SV) may increase during systemic chemotherapy, potentially reflecting treatment-related hepatic, hematological, and immune alterations. However, the clinical significance of SV changes during neoadjuvant chemotherapy (NAC) for gastric cancer remains unclear. This study evaluated SV changes during NAC and their associations with radiological response and overall survival (OS). Methods: This retrospective cohort study included 111 patients with gastric adenocarcinoma who received NAC followed by curative-intent gastrectomy. SV was measured on computed tomography before and after NAC using semiautomated volumetric segmentation. Relative SV change (ΔSV%) was calculated. Radiological response was assessed according to RECIST 1.1. Associations of ΔSV% with objective response and OS were evaluated using logistic and Cox regression analyses, respectively. Results: Mean SV increased significantly from 250.59 ± 98.11 to 335.40 ± 126.81 cm3 (p < 0.001), with a mean ΔSV% of 34.53 ± 15.72%. SV increased in 108 patients (97.3%). Objective response was observed in 56 patients (50.5%). ΔSV% did not differ between responders and nonresponders (34.05 ± 15.66% vs. 35.03 ± 15.90%; p = 0.730) and was not associated with objective response after multivariable adjustment (OR per 10% increase, 0.932; 95% CI, 0.715–1.207; p = 0.578). ΔSV% was also not associated with OS (adjusted HR, 1.031; 95% CI, 0.859–1.236; p = 0.745). Conclusions: SV increased markedly in nearly all patients during NAC for gastric cancer. However, the magnitude of this increase was not associated with radiological response or OS, suggesting that splenic enlargement during NAC may represent a treatment-associated phenomenon rather than a marker of antitumor efficacy or prognosis.
SN  - 2077-0383
ER  -