Perforated gastric carcinoma: a report of 10 cases and review of the literature
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Perforated gastric carcinoma: a report of 10 cases and review of the literature Franco Roviello*1, Simone Rossi1, Daniele Marrelli1, Giovanni De Manzoni2, Corrado Pedrazzani2, Paolo Morgagni3, Giovanni Corso1 and Enrico Pinto1 Address: 1Dipartimento di Chirurgia Generale ed Oncologica, University of Siena, Italy, 2Istituto di Semeiotica Chirurgica, University of Verona, Italy and 3Divisione di Chirurgia 1, G.B. Morgagni Hospital, Forlì, Italy Email: Franco Roviello* - [email protected]; Simone Rossi - [email protected]; Daniele Marrelli - [email protected]; Giovanni De Manzoni - [email protected]; Corrado Pedrazzani - [email protected]; Paolo Morgagni - [email protected]; Giovanni Corso - [email protected]; Enrico Pinto - [email protected] * Corresponding author
Published: 30 March 2006 World Journal of Surgical Oncology 2006, 4:19
doi:10.1186/1477-7819-4-19
Received: 07 October 2005 Accepted: 30 March 2006
This article is available from: http://www.wjso.com/content/4/1/19 © 2006 Roviello et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Perforation is a rare complication of gastric carcinoma, accounting for less than 1% of all gastric cancer cases. The aim of the present study is to evaluate the prognostic value of perforation and to point out the surgical treatment options. Methods: A total of 10 patients with perforated gastric carcinoma were retrospectively reviewed among 2564 consecutive cases of gastric cancer operated in three Centers belonging to the Italian Research Group for Gastric Cancer. The clinicopathological features including tumor stage and survival were analyzed and compared to literature data. Results: Incidence rate was 0.39%. All patients underwent emergency surgery, being performed gastrectomy in 6 patients (mortality 17%) and repair surgery in 4 patients (mortality 75%). The survival of patients was related to the stage of the disease, with 2 long-survival cases. Conclusion: Perforation usually occurs in advanced stages of gastric cancer; nevertheless surgeons should not be always discouraged from a radical treatment of perforated gastric cancer, since perforation even occurs in early stages and seems not to be a negative prognostic factor itself. When possible, emergency gastrectomy should be performed, leaving repair surgery for unresectable tumors. A two-stage treatment is a good treatment option for frail patients with resectable tumors.
Background Perforation of gastric carcinoma results in an acute abdominal syndrome due to the spilled gastric contents and the consequent peritonitis. It is a rare condition representing less than 1% of gastric cancer cases in the reports of the last years[1,2] and up to 6% in reports dated before 1980 [3-5]; it has been reported that about 10
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