Long-term survival after gastrectomy for advanced bleeding or perforated gastric carcinoma.

OBJECTIVE

To find out whether massive bleeding or free perforation of advanced gastric carcinoma affect long term survival after gastrectomy.

DESIGN

Retrospective analysis of prospectively collected data.

SETTING

Teaching hospital, Hong Kong.

INTERVENTIONS

Gastrectomy.

MAIN OUTCOME MEASURES

Long term survival.

RESULTS

Data of 50 patients with gastric carcinoma that had penetrated the serosa (pT3) and who were operated on between 1985 and 1990 were analysed. A total of 17 patients with tumour free perforation and 10 with massive bleeding underwent emergency gastrectomy, and 23 patients with comparable uncomplicated tumours had elective gastrectomy. Twelve variables that could have influenced survival including malignant perforation, bleeding, or the absence of complications were analysed using the Cox's proportional hazards model. Survival was influenced only by proliferative cell nuclear antigen (PCNA) index and not by perforation, bleeding, or the uncomplicated nature of the tumour.

CONCLUSIONS

These findings suggest that perforation or bleeding from advanced gastric carcinomas do not significantly affect long term survival after gastrectomy.