Surgical treatment of perforated gastric tumors.
코호트
1/5 보강
PICO 자동 추출 (휴리스틱, conf 3/4)
유사 논문P · Population 대상 환자/모집단
26 patients (72.
I · Intervention 중재 / 시술
one-stage gastrectomy
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
On multivariable analysis, gastrectomy was independently associated with improved survival ( = 0.026). [CONCLUSION] When clinically feasible, gastrectomy-either immediate or delayed-provides superior survival compared to local perforation repair alone in patients with PGC.
[BACKGROUND] Perforated gastric cancer (GC) is a rare but life-threatening surgical emergency.
- 연구 설계 cohort study
APA
Aguiar MFF, Pereira MA, et al. (2025). Surgical treatment of perforated gastric tumors.. World journal of gastrointestinal surgery, 17(11), 110490. https://doi.org/10.4240/wjgs.v17.i11.110490
MLA
Aguiar MFF, et al.. "Surgical treatment of perforated gastric tumors.." World journal of gastrointestinal surgery, vol. 17, no. 11, 2025, pp. 110490.
PMID
41357643
Abstract
[BACKGROUND] Perforated gastric cancer (GC) is a rare but life-threatening surgical emergency. Optimal surgical management remains controversial, and evidence from high-volume centers, especially in Western countries, is limited.
[AIM] To evaluate surgical and survival outcomes of patients with perforated GC (PGC) according to the initial treatment strategy.
[METHODS] A retrospective cohort study was conducted including all patients with pathologically confirmed perforated gastric adenocarcinoma treated at a single tertiary cancer center between January 2009 and March 2024. Surgical strategies were categorized as gastrectomy or primary perforation repair. Outcomes analyzed included 30- and 90-day mortality, postoperative major complications, and overall survival (OS).
[RESULTS] Among 1586 GC patients undergoing surgical treatment, 36 (2.3%) presented with PGC. The mean age was 62.5 years, and 55% were male. American Society of Anesthesiologists (ASA) class III/IV was present in 58.3%, and 83% had stage IV disease, with distant metastasis in 50%. Perforation repair was performed in 26 patients (72.2%), while 10 (27.8%) underwent one-stage gastrectomy. ASA III/IV status (57.7% 30%, = 0.260) and metastatic disease (57.7% 30%, = 0.137) were more frequent in the Perforation Repair Group, though not statistically significant. This group also had a higher rate of diffuse-type and poorly differentiated tumors ( = 0.024 and = 0.014, respectively). Thirty- and 90-day mortality were higher in the Perforation Repair Group (61.5% 30%, = 0.139; and 65.4% 30%, = 0.073), without significance. Three patients initially repaired were later referred for gastrectomy. OS was significantly better in the Gastrectomy Group ( = 0.002), with median survival of 8.8 months 0.5 months. On multivariable analysis, gastrectomy was independently associated with improved survival ( = 0.026).
[CONCLUSION] When clinically feasible, gastrectomy-either immediate or delayed-provides superior survival compared to local perforation repair alone in patients with PGC.
[AIM] To evaluate surgical and survival outcomes of patients with perforated GC (PGC) according to the initial treatment strategy.
[METHODS] A retrospective cohort study was conducted including all patients with pathologically confirmed perforated gastric adenocarcinoma treated at a single tertiary cancer center between January 2009 and March 2024. Surgical strategies were categorized as gastrectomy or primary perforation repair. Outcomes analyzed included 30- and 90-day mortality, postoperative major complications, and overall survival (OS).
[RESULTS] Among 1586 GC patients undergoing surgical treatment, 36 (2.3%) presented with PGC. The mean age was 62.5 years, and 55% were male. American Society of Anesthesiologists (ASA) class III/IV was present in 58.3%, and 83% had stage IV disease, with distant metastasis in 50%. Perforation repair was performed in 26 patients (72.2%), while 10 (27.8%) underwent one-stage gastrectomy. ASA III/IV status (57.7% 30%, = 0.260) and metastatic disease (57.7% 30%, = 0.137) were more frequent in the Perforation Repair Group, though not statistically significant. This group also had a higher rate of diffuse-type and poorly differentiated tumors ( = 0.024 and = 0.014, respectively). Thirty- and 90-day mortality were higher in the Perforation Repair Group (61.5% 30%, = 0.139; and 65.4% 30%, = 0.073), without significance. Three patients initially repaired were later referred for gastrectomy. OS was significantly better in the Gastrectomy Group ( = 0.002), with median survival of 8.8 months 0.5 months. On multivariable analysis, gastrectomy was independently associated with improved survival ( = 0.026).
[CONCLUSION] When clinically feasible, gastrectomy-either immediate or delayed-provides superior survival compared to local perforation repair alone in patients with PGC.