Perforated Gastric Cancer -A Clinicopathological Study of Eight Cases-

Taichi Kanamaru, Yoichi Saitou, Kyousuke Ota*, Yoshinari Hashimoto*, Shouji Matsui*, Hiroshi Fukuda*, Tsutomu Fujimoto*

First Department of Surgery, Kobe University, School of Medicine
*Department of Surgery, Kakogawa Municipal Hospital

Eight cases of acute perforated gastric cancer were investigated, clinicopathologically. The patients were all treated in the surgical department of Kakogawa Municipal Hospital from 1976 to 1990. Acute perforation occurred in 0.9% of all 847 patients with gastric cancer. The sex ratio was 6:2 (male to female), and the mean age was 66.5 years, which is higher than that for ulcer perforation. Correct diagnosis of the perforated gastric cancer was made in only one case. The site of the perforation was the cardia in 4 cases, the body in 2 cases, and the prepylorus in 2 cases, and the perforation occurred in the ulcerating tumor in every case. The tumor was resectable in 6 cases (75%), but only 1 resection was curative. Two of the tumors were classified, macroscopically, as Borrmann type 2, type 3, and type IIc+III advanced respectively. Histological examination revealed that 3 tumors were poorly differentiated adenocarcinoma, 2 moderately differentiated adenocarcinoma, and 1 mucinous adenocarcinoma. The deepest layer of cancerous invasion was "ss" in 4 cases, "se" in 1 case, and "sei" in 1 case. There were 2 operative deaths; the tumors could not be resected. Four of the other 6 patients died of peritoneal carcinomatosis. Perforated cancer was 32% of all the gastric perforations. Therefore it is important to diagnose the cause of the perforation carefully. For perforated gastric cancer, a curative operation should be the principal method of treatment.

Key words
clinicopathological study of the perforated gastric cancer

Reprint requests
Taichi Kanamaru First Department of Surgery, Kobe University, School of Medicine
7-5-2 Kusunoki, Chuo, Kobe, 650 JAPAN

Accepted
January 13, 1993

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