Li DQ, Lin ZY, Wang JG, Wu RQ, Zhang Y, Du ZQ. Splenectomy and risk of hepatocellular carcinoma. World J Hepatol 2025; 17(7): 107603 [DOI: 10.4254/wjh.v17.i7.107603]
Corresponding Author of This Article
Zhao-Qing Du, MD, PhD, Academic Editor, Postdoctoral Researcher, Researcher, Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, No. 256 West Youyi Road, Xi’an 710068, Shaanxi Province, China. duzhaoqing2007@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Da-Qing Li, Zhen-Yi Lin, Jian-Guo Wang, Yu Zhang, Zhao-Qing Du, Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Da-Qing Li, Xi’an Medical University, Xi’an 710021, Shaanxi Province, China
Zhen-Yi Lin, National University of Singapore, Singapore 117597, Singapore
Rong-Qian Wu, National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Zhao-Qing Du, National Engineering Research Center for Miniaturized Detection Systems, College of Life Sciences, Northwest University, Xi’an 710069, Shaanxi Province, China
Author contributions: Li DQ and Du ZQ contributed to conceptualization, data curation, and writing of the original draft; Lin ZY, Wang JG, Wu RQ, Zhang Y, and Du ZQ contributed to manuscript review and editing; Du ZQ contributed to funding acquisition; all authors read and approved the final version of the manuscript to be published.
Supported by National Natural Science Foundation of China, No. 82200686.
Conflict-of-interest statement: All authors report no potential conflicts of interest in relation to this study.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao-Qing Du, MD, PhD, Academic Editor, Postdoctoral Researcher, Researcher, Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, No. 256 West Youyi Road, Xi’an 710068, Shaanxi Province, China. duzhaoqing2007@126.com
Received: March 27, 2025 Revised: April 29, 2025 Accepted: June 20, 2025 Published online: July 27, 2025 Processing time: 120 Days and 20.1 Hours
Abstract
Hypersplenism is a common complication of cirrhosis that is associated with significant impairment to patients' life quality. Splenectomy is often employed in clinical settings as a treatment for hypersplenism. While splenectomy is carried out for the purposes of alleviating hypersplenism-related adverse outcomes like thrombocytopenia or anaemia, studies have suggested alterations in the immune status, hemodynamics, and intestinal microbiota of patients following splenectomy, which may potentially influence the onset and progression of hepatocellular carcinoma (HCC). Additionally, patients have been found to face new health risks post-splenectomy, including infections and thrombosis, which could adversely impact their overall health and potentially increase the risk of HCC. Despite these findings, there is currently no consensus on whether splenectomy affects the risk of postoperative HCC in cirrhotic patients. This review synthesizes the pertinent literature on the incidence of HCC following splenectomy, with an emphasis on current evidence related to its physiology, pathophysiology, and epidemiology. Concepts such as immune status, hemodynamics changes, and intestinal microbiota in post-splenectomy patients are explored, in hopes that it can inform more individualized treatment approaches for patients.
Core Tip: Hypersplenism, a frequent complication of cirrhosis, often requires splenectomy to alleviate conditions like thrombocytopenia and anemia. However, splenectomy may alter immune status and hemodynamics, potentially influencing hepatocellular carcinoma (HCC) development. Post-splenectomy risks, including infections and thrombosis, further complicate outcomes. Current evidence on the splenectomy-HCC relationship remains inconclusive, necessitating further research into pathophysiology and epidemiology. This review examines immune, hemodynamic, and gut microbiota changes post-splenectomy to guide individualized treatment strategies for cirrhotic patients.
