Clinicopathological features, surgical management, and disease outcome of perforated gastric cancer

Shyh Chuan Jwo*, Rong Nan Chien, Tzu Chien Chao, Huang Yang Chen, Chin Yew Lin

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

30 Scopus citations


Background and Objectives: Perforated gastric cancer is rare and generally not diagnosed preoperatively or intraoperatively, if a frozen section is unavailable. Therefore, the elucidation of its Clinicopathological features and disease outcomes will help surgeons manage perforated gastric cancer. Patients and Methods: The Clinicopathological features, surgical management, and disease outcomes of 13 patients with perforated gastric cancer from March 1989 to May 2003 were retrospectively analyzed. Disease outcomes were analyzed in-depth based on tumor stage, depth of tumor invasion, operative curability, and three treatment groups. Results: All 13 patients (median age of 72 years) received emergent laparotomy. Malignant gastric perforation was diagnosed intraoperatively in eight (61.5%) patients. Four patients whose frozen sections exhibited perforated gastric cancer underwent radical surgery with curative intent and were assigned to Group 1. Another four patients with overt distal metastases underwent palliative surgery and were assigned to Group 2. The remaining five patients were misdiagnosed as having benign gastric perforation and underwent local surgery; these patients were assigned to Group 3. All patients received follow-up for a median of 26 months. The survival rates for Stage I disease (P = 0.0342), T1/T2 tumors (P = 0.0342), and curative resection (P = 0.0012) significantly exceeded those of Stage III/IV, T3/T4 tumors, and noncurative resection. Additionally, the survival rates of Group 1 (P = 0.0067) and Group 3 (P = 0.0067) significantly exceeded those of Group 2. Stepwise logistic regression analysis revealed no significant predictor of prognosis. Conclusions: In resectable cases, one-stage radical gastrectomy with possible extensive lymphadenectomy should be encouraged if conditions allow. In cases of misdiagnosis, non-radical local surgery with curative resection is sufficient to treat early-stage cancer.

Original languageEnglish
Pages (from-to)219-225
Number of pages7
JournalJournal of Surgical Oncology
Issue number4
StatePublished - 15 09 2005
Externally publishedYes


  • Clinicopathological features
  • Disease outcome
  • Perforated gastric cancer
  • Surgical management


Dive into the research topics of 'Clinicopathological features, surgical management, and disease outcome of perforated gastric cancer'. Together they form a unique fingerprint.

Cite this