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Clinical Outcomes and Prognostic Factors of Metastatic Gastric Carcinoma Patients Who Experience Gastrointestinal Perforation During Palliative Chemotherapy

  • Gastrointestinal Oncology
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Annals of Surgical Oncology Aims and scope Submit manuscript

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Abstract

Background

We conducted the current study to investigate the clinical outcomes of metastatic gastric carcinoma (MGC) patients who experienced gastrointestinal (GI) perforation during palliative chemotherapy and to examine the prognostic factors associated with survival after perforation.

Methods

We reviewed the medical records of patients at the Center for Gastric Cancer of the National Cancer Center, Korea who developed GI perforation during palliative chemotherapy between January 2001 and December 2008.

Results

Of the 1,856 patients who received palliative chemotherapy for MGC, 32 patients (1.7%) developed GI perforation during chemotherapy. Patients with perforation at the primary gastric site were more likely to have ulcerative gastric cancer lesion (90.5 vs. 40.0%, P = 0.034) or gastric tumor bleeding (28.6 vs. 0%, P = 0.298), and less likely to have Bormann type IV (14.3 vs. 60.0%, P = 0.062), than patients with perforation at nongastric sites. In 14 patients (43.8%) who resumed chemotherapy after perforation, the disease control rate was 57.1%, and median overall survival (OS) after perforation was 7.5 months [95% confidence interval (CI), 6.0–9.0 months]. In all patients, median OS following perforation was 4.0 months (95% CI, 1.5–6.6 months), and multivariate analysis revealed that differentiated tumor histology, response to chemotherapy before perforation, and absence of septic shock at time of perforation were significantly associated with favorable OS after perforation.

Conclusions

As patients experiencing GI perforation during palliative chemotherapy have heterogeneous clinical presentation, we need to adopt different approaches in the management of the patients that are compatible with the favorable prognostic factors.

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Acknowledgment

This study was supported by grants 0710650 and 1010180 from Research Institute and Hospital, National Cancer Center, Republic of Korea.

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Authors and Affiliations

  1. Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea

    Myoung Hee Kang MD, Shi Nae Kim MD, Noe Kyeong Kim MD, PhD, Young-Iee Park MD, PhD, Young-Woo Kim MD, PhD, Keun Won Ryu MD, PhD, Jun Ho Lee MD, PhD, Jong Seok Lee MD & Sook Ryun Park MD, PhD

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  1. Myoung Hee Kang MD
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  2. Shi Nae Kim MD
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  3. Noe Kyeong Kim MD, PhD
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  4. Young-Iee Park MD, PhD
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  5. Young-Woo Kim MD, PhD
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  6. Keun Won Ryu MD, PhD
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  7. Jun Ho Lee MD, PhD
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  8. Jong Seok Lee MD
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  9. Sook Ryun Park MD, PhD
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Correspondence to Sook Ryun Park MD, PhD.

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Kang, M.H., Kim, S.N., Kim, N.K. et al. Clinical Outcomes and Prognostic Factors of Metastatic Gastric Carcinoma Patients Who Experience Gastrointestinal Perforation During Palliative Chemotherapy. Ann Surg Oncol 17, 3163–3172 (2010). https://doi.org/10.1245/s10434-010-1164-3

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  • DOI: https://doi.org/10.1245/s10434-010-1164-3

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