A STUDY ON OPERATED CASES OF PERFORATED GASTRIC CANCER

Among 379 cases operated on for gastric cancer at the department in a past 8-year period, 8 cases (2.1%) had a perforated gastric cancer. In this paper these 8 cases were clinicopathologically studied. Prceoperative diagnosis was able to be made in only 2 cases. As to operative findings, the perforated cancer was frequently found in region M (4 cases). These patients predominantly had an advanced cancer. namely, 2 patients had a Stage I cancer; one, Stage II cancer; 3 Stage III cancer; and 2, Stage IV cancer. Gastrectomy was carried out in 6 cases, which turned out curative resection in 2 cases. Invasion depth of the cancers was sm in 2 cases, ssβ in 3, ssγ in one, and se in 2. Perforation of early gastric cancer was noted in 2 cases. There were 2 operative deaths and one death during hospital stay, which occurred in aged patients over 80 years old. Two curative resection cases survive more than 5 years. According to Osawa's classification of perforated sites, direct perforation type might have poor prognosis compared to that of indirect perforation type. Even patients with perforated gastric cancer can expect good prognosis by radical operation on an one-step approach as far as conditions permit. For that, accurate diagnostic methods and appropriate lymph node dissection are important.