An analysis of 13 patients with perforated gastric carcinoma: A surgeon's nightmare?

BACKGROUND AND OBJECTIVES Perforation is a rare complication of gastric carcinoma and generally not diagnosed preoperatively. To clarify the clinicopathologic characteristics of patients with this condition we reviewed 13 cases of gastric cancer perforation who required emergency surgery. METHODS A total of 13 patients with gastric cancer perforation were retrospectively reviewed. The clinicopathological features including tumor stage and survival and also the type of treatment were analyzed and compared to literature data. RESULTS There were 13 patients (10 males and 3 females) with a mean age of 59.0 +/- 9.56 years. The incidence of perforated gastric cancer was 9.6% among gastric carcinoma and 4.2% of all gastric perforation cases. The perforation was more frequently in stage III-IV (2-10), but one case of stage II (T3N0M0) gastric cancer was also observed. None of the patients had curative resection or radical lymph-node dissection. Six (46%) patients were treated by palliative, local surgery. Emergency gastrectomy were performed in 7 (54%) patients. Overall 30-day mortality rate was % 46. The overall survival time was 128.2 +/- 184.8 days for all patients, it was 52.8 +/- 52.9 days for locally treated group, and 192.9 +/- 235.4 days for patients who underwent resectional surgery. The difference between the treatment groups was not significant CONCLUSION Perforation usually occurs in advanced stages of gastric cancer. These patients had a poor prognosis because of the presence of advanced cancer.