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Perforated gastric cancer: a critical appraisal
Gastric cancer perforation is a life-threatening condition that accounts for less than 5% of all gastric cancer patients and typically requires emergency surgery. However, preoperative diagnosis is difficult and management has a dual purpose: to treat peritonitis and to achieve a curative resection....
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8777488/ https://www.ncbi.nlm.nih.gov/pubmed/35201463 http://dx.doi.org/10.1007/s12672-021-00410-z |
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author | Di Carlo, Sara Franceschilli, Marzia Rossi, Piero Cavallaro, Giuseppe Cardi, Maurizio Vinci, Danilo Sibio, Simone |
author_facet | Di Carlo, Sara Franceschilli, Marzia Rossi, Piero Cavallaro, Giuseppe Cardi, Maurizio Vinci, Danilo Sibio, Simone |
author_sort | Di Carlo, Sara |
collection | PubMed |
description | Gastric cancer perforation is a life-threatening condition that accounts for less than 5% of all gastric cancer patients and typically requires emergency surgery. However, preoperative diagnosis is difficult and management has a dual purpose: to treat peritonitis and to achieve a curative resection. The optimal surgical strategy is still unclear and prognosis remains poor. A search of the literature was performed using MEDLINE databases (Pubmed, EMBASE, Web of Science and Cochrane) using terms such as “perforated gastric cancer”, “perforated gastric cancer and surgery”, “perforated gastric tumour” and “gastric cancer perforated”. Case reports, other reviews, non-english written papers and papers written before 2010 were excluded. Eight articles published between 2010 and 2020 matched the inclusion criteria for this review. Perforated gastric cancer was more prevalent in elderly males. Distal stomach was most frequently involved. Preoperative diagnosis was uncommon. Mortality rates ranged from 2 to 46%. Patients able to receive an R0 resection demonstrated better long-term survival compared with patients who had simple closure procedures. Laparoscopic procedure was mentioned only in one study. In an emergency situation, curative RO resection should always be offered in patients without multiple adverse factors. A surgical strategy using laparoscopic local repair as first step of surgery to resolve the peritonitis followed by a radical open or laparoscopic gastrectomy with lymphadenectomy could be considered. A balance between emergency and oncological needs should drive the surgical choice on a case by case basis. |
format | Online Article Text |
id | pubmed-8777488 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-87774882022-02-03 Perforated gastric cancer: a critical appraisal Di Carlo, Sara Franceschilli, Marzia Rossi, Piero Cavallaro, Giuseppe Cardi, Maurizio Vinci, Danilo Sibio, Simone Discov Oncol Review Gastric cancer perforation is a life-threatening condition that accounts for less than 5% of all gastric cancer patients and typically requires emergency surgery. However, preoperative diagnosis is difficult and management has a dual purpose: to treat peritonitis and to achieve a curative resection. The optimal surgical strategy is still unclear and prognosis remains poor. A search of the literature was performed using MEDLINE databases (Pubmed, EMBASE, Web of Science and Cochrane) using terms such as “perforated gastric cancer”, “perforated gastric cancer and surgery”, “perforated gastric tumour” and “gastric cancer perforated”. Case reports, other reviews, non-english written papers and papers written before 2010 were excluded. Eight articles published between 2010 and 2020 matched the inclusion criteria for this review. Perforated gastric cancer was more prevalent in elderly males. Distal stomach was most frequently involved. Preoperative diagnosis was uncommon. Mortality rates ranged from 2 to 46%. Patients able to receive an R0 resection demonstrated better long-term survival compared with patients who had simple closure procedures. Laparoscopic procedure was mentioned only in one study. In an emergency situation, curative RO resection should always be offered in patients without multiple adverse factors. A surgical strategy using laparoscopic local repair as first step of surgery to resolve the peritonitis followed by a radical open or laparoscopic gastrectomy with lymphadenectomy could be considered. A balance between emergency and oncological needs should drive the surgical choice on a case by case basis. Springer US 2021-05-15 /pmc/articles/PMC8777488/ /pubmed/35201463 http://dx.doi.org/10.1007/s12672-021-00410-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Review Di Carlo, Sara Franceschilli, Marzia Rossi, Piero Cavallaro, Giuseppe Cardi, Maurizio Vinci, Danilo Sibio, Simone Perforated gastric cancer: a critical appraisal |
title | Perforated gastric cancer: a critical appraisal |
title_full | Perforated gastric cancer: a critical appraisal |
title_fullStr | Perforated gastric cancer: a critical appraisal |
title_full_unstemmed | Perforated gastric cancer: a critical appraisal |
title_short | Perforated gastric cancer: a critical appraisal |
title_sort | perforated gastric cancer: a critical appraisal |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8777488/ https://www.ncbi.nlm.nih.gov/pubmed/35201463 http://dx.doi.org/10.1007/s12672-021-00410-z |
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