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KMID : 0914820020020020085
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Journal of the Korean Gastric Cancer Association
2002 Volume.2 No. 2 p.85 ~ p.90
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Surgical Result for Perforated Gastric Cancer
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Lee Moon-Soo
Chae Man-Kyu
Kim Tae-Yoon
Cho Gyu-Seok
Kim Sung-Yong
Baek Moo-Jun
Chung Il-Kwon
Park Kyung-Kyu
Kim Chang-Ho
Song Ok-Pyung
Cho Moo-Sik
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Abstract
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Purpose: Perforated gastric cancer (PGC) is rare and occurs in 1∼4% of all gastric cancers. Possible dissemination of tumor cells at the time of perforation of the gastric carcinoma has been a matter of concern. The intraoperative determination of what kind of operation should be done and how extensive the lymphnode dissection should be still remains controversial. The purpose of this study is to evaluate the factors influencing the survival and to determine the optimal treatment for PGC.
Materials and Methods: A total of 42 patients were operated on for a perforated gastric carcinoma at Soonchunhyang University Chunan Hospital from 1983 to 2000. the age and the sexes of the patients, the location of perforation, the diameter of perforation, the histologic type of the tumor, the depth of wall invasion, the absence or presence of lymph node metastasis / distant metastasis, the stage of disease, the type of operation, and the outcomes were examined. Statistically significant differences were analyzed by using Fisher’s exact test.
Results: The stage distributions according to the UICC classification were 1 case of stage I, 6 cases of stage II, 17 cases of stage III, and 11 cases of stage IV. An emergency gastrectomy was done in 26 patients (61.9%), with a 5-yrsurvival rate of 44%. The survival of patients was significantly influenced by the depth of wall invasion, the lymphnode metastasis, distant metastasis, the stage of disease, and the type of operation.
Conclusions: an emergency gastrectomy is the treatment of choice for most patients with resectable PGC. Choosing more a optimistic surgical approach for potentially curative cases of PGC should be one way to increase the patient’s survival rate.
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KEYWORD
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Gastric cancer, Perforation, Emergency gastrectomy
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