Outcome after emergency surgery in gastric cancer patients with free perforation or severe bleeding.
This study was conducted to evaluate the clinicopathologic characteristics and surgical outcome of perforated or bleeding gastric cancer patients. Twenty-six gastric cancer patients undergoing emergency surgery for free perforation (n = 13) or severe bleeding (n = 13) were reviewed. In the perforation group, tumors were mainly located in the greater curvature and anterior wall, but in the bleeding group, they were mainly in the lesser curvature. Three (23%) patients in the perforation group and 7 (54%) in the bleeding group received potentially curative resections (p = 0.11). The postoperative morbidity rate and mortality rate were 31 (8/26) and 8% (2/26), respectively. Median survival time after operation was 5.5 months. One patient in the perforation group and 3 patients in the bleeding group who underwent curative resection survived more than 30 months without recurrence. Three factors were found to be associated with improved survival after emergency surgery: potentially curative resection; TNM stage, and the absence of postoperative complications. Emergency surgery for gastric cancer patients with perforation or severe bleeding is associated with a low curative resection rate and a high postoperative complication rate. However, long-term survival can be expected in those patients who underwent curative resection with earlier stage gastric cancer.