Alarm from the peritoneum: Gastrointestinal perforations in cancer patients, with a focus on perforations of unknown origin

Table 1 Patients’ characteristics according to perforation etiology

Characteristics	Cancer-related cause (n = 80)	Cancer-unrelated cause (n = 28)	Unknown cause (n = 11)
Age at diagnosis (year)	63.0 ± 12.22	66.7 ± 9.73	65.9 ± 8.99
Sex
Female	38 (47.5)	12 (42.9)	4 (36.4)
Male	42 (52.5)	16 (57.1)	7 (63.6)
Primary tumor site
Colon	33 (41.3)	3 (10.7)	1 (9.1)
Hematological cancer	3 (3.8)	3 (10.7)	1 (9.1)
Breast	0 (0.0)	5 (17.9)	1 (9.1)
Pancreas	7 (8.8)	3 (10.7)	0 (0.0)
Lung	0 (0.0)	4 (14.3)	3 (27.3)
Kidney	0 (0.0)	2 (7.1)	3 (27.3)
Rectum	9 (11.3)	1 (3.6)	1 (9.1)
Multiple sites	1 (1.3)	0 (0.0)	0 (0.0)
Stomach	13 (16.3)	2 (7.1)	0 (0.0)
Other sites	14 (17.5)	5 (17.9)	1 (9.1)
Metastatic disease
No	24 (30.0)	9 (32.1)	4 (36.4)
Yes	55 (69.8)	19 (67.9)	7 (63.6)
Unknown	1 (1.3)	0 (0.0)	0 (0.0)
Number of metastatic sites
1	33 (60.0)	13 (68.4)	3 (42.9)
2	17 (30.9)	2 (10.5)	3 (42.9)
3	5 (9.1)	3 (15.8)	0 (0.0)
4	0 (0.0)	1 (5.3)	1 (14.3)
Site of metastases
Lung	13 (16.3)	3 (10.7)	3 (27.3)
Lymph nodes	10 (12.5)	7 (25.0)	3 (27.3)
Bone	2 (2.5)	9 (32.1)	3 (27.3)
Peritoneum	27 (33.8)	2 (7.1)	0 (0.0)
Brain	3 (3.8)	1 (3.6)	1 (9.1)
Adrenal gland	0 (0.0)	0 (0.0)	1 (9.1)
Skin	1 (1.3)	0 (0.0)	0 (0.0)
Stomach	2 (2.5)	1 (3.6)	0 (0.0)
Liver	19 (23.8)	3 (10.7)	2 (18.2)
Ovary	1 (1.3)	0 (0.0)	0 (0.0)
Uterus	1 (1.3)	0 (0.0)	0 (0.0)
Pancreas	1 (1.3)	0 (0.0)	0 (0.0)
Kidney	1 (1.3)	1 (3.6)	0 (0.0)
Colon	0 (0.0)	1 (3.6)	0 (0.0)
Muscle	1 (1.3)	1 (3.6)	0 (0.0)
Site of perforation
Gallbladder	0 (0.0)	1 (3.6)	0 (0.0)
Colon	22 (27.5)	2 (7.1)	5 (45.5)
Small intestine	19 (23.8)	3 (10.7)	3 (27.3)
Rectosigmoid	16 (20.0)	17 (60.7)	1 (9.1)
Unknown	14 (17.5)	4 (14.3)	2 (18.2)
Stomach/cardia	8 (10.0)	1 (3.6)	0 (0.0)
Bladder	1 (1.3)	0 (0.0)	0 (0.0)
Surgery
No	30 (37.5)	9 (32.1)	3 (27.3)
Yes	50 (62.5)	19 (67.9)	7 (63.6)
Unknown	0 (0.0)	0 (0.0)	1 (9.1)
Surgical technique
Resection + stoma	21 (42.0)	7 (36.8)	3 (42.9)
Stoma only	2 (4.0)	1 (5.3)	0 (0.0)
Resection	25 (50.0)	8 (42.1)	4 (57.1)
Drainage only	1 (2.0)	1 (5.3)	0 (0.0)
Others	1 (2.0)	2 (10.5)	0 (0.0)
Time to surgery (day)	1.0 (1-10)	1.5 (1-22)	1.0 (10-23)
Comorbidities
No comorbidities	44 (55.0)	10 (35.7)	2 (18.2)
Inflammatory bowel disease	1 (1.3)	1 (3.6)	0 (0.0)
Arterial hypertension	20 (25.0)	9 (32.1)	7 (63.6)
Ischemic heart disease	1 (1.3)	0 (0.0)	2 (18.2)
Renal insufficiency	2 (2.5)	1 (3.6)	0 (0.0)
Rheumatologic disease	1 (1.3)	1 (3.6)	0 (0.0)
Metabolic syndrome	7 (8.8)	4 (14.3)	1 (9.1)
Aortic aneurysm	2 (2.5)	0 (0.0)	0 (0.0)
COPD	4 (5.0)	1 (3.6)	0 (0.0)
Atrial fibrillation	3 (3.8)	1 (3.6)	0 (0.0)
Hypothyroidism	5 (6.3)	2 (7.1)	1 (9.1)
Active infection
No	69 (86.3)	24 (85.7)	9 (81.8)
Yes	1 (1.3)	1 (3.6)	0 (0.0)
Unknown	10 (12.5)	3 (10.7)	2 (18.2)
Corticosteroid therapy within 7 days before perforation
No	18 (22.5)	7 (25.0)	3 (27.3)
Yes	22 (27.5)	13 (46.4)	5 (45.5)
Unknown	40 (50.0)	8 (28.6)	3 (27.3)
Chemotherapy
With known perforation risk	20 (25.0)	9 (32.1)	4 (36.4)
Without known perforation risk	26 (32.5)	9 (32.1)	5 (45.5)
No chemotherapy	34 (42.5)	10 (35.7)	2 (18.2)
Antibiotic therapy within 7 days before perforation
No	33 (41.3)	7 (25.0)	5 (45.5)
Yes	2 (2.5)	7 (25.0)	0 (0.0)
Unknown	45 (56.3)	14 (50.0)	6 (54.5)

Continuous variables were summarized using means ± SD or medians (interquartile ranges), as appropriate, while categorical variables were reported as absolute n (%). COPD: Chronic obstructive pulmonary disease.