Aguiar MFF, Pereira MA, Dias AR, Ribeiro Jr U, Ramos MFKP. Surgical treatment of perforated gastric tumors. World J Gastrointest Surg 2025; 17(11): 110490 [DOI: 10.4240/wjgs.v17.i11.110490]
Corresponding Author of This Article
Marcus Fernando Kodama Pertille Ramos, MD, PhD, Department of Gastroenterology, Instituto do Cancer, Instituto do Cancer, Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Dr Arnaldo 251, Sao Paulo 01249000, Brazil. marcus.kodama@hc.fm.usp.br
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Nov 27, 2025; 17(11): 110490 Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.110490
Surgical treatment of perforated gastric tumors
Matheus Felipe Ferreira Aguiar, Marina Alessandra Pereira, Andre Roncon Dias, Ulysses Ribeiro Jr, Marcus Fernando Kodama Pertille Ramos
Matheus Felipe Ferreira Aguiar, Marina Alessandra Pereira, Andre Roncon Dias, Ulysses Ribeiro Jr, Marcus Fernando Kodama Pertille Ramos, Department of Gastroenterology, Instituto do Cancer, Instituto do Cancer, Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01249000, Brazil
Co-first authors: Matheus Felipe Ferreira Aguiar and Marina Alessandra Pereira.
Author contributions: Aguiar MFF and Pereira MA contribute equally to this study as co-first authors; Aguiar MFF collected the data, performed the critical analysis, and wrote the manuscript; Pereira MA collected the data, analyzed the data, performed the critical analysis and wrote the manuscript; Dias AR and Ribeiro Jr U performed the critical analysis and reviewed the manuscript; Ramos MFKP designed the research study, collected the data, performed the critical analysis, and wrote the manuscript.
Institutional review board statement: The study was approved by the hospital ethics committee and registered online (https://plataformabrasil.saude.gov.br; CAAE: 47012521.3.0000.0068).
Informed consent statement: Informed consent was waived by the local Ethics Committee because of the retrospective nature of the study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marcus Fernando Kodama Pertille Ramos, MD, PhD, Department of Gastroenterology, Instituto do Cancer, Instituto do Cancer, Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Dr Arnaldo 251, Sao Paulo 01249000, Brazil. marcus.kodama@hc.fm.usp.br
Received: June 10, 2025 Revised: July 5, 2025 Accepted: September 11, 2025 Published online: November 27, 2025 Processing time: 171 Days and 4.2 Hours
Core Tip
Core Tip: This retrospective study evaluated the clinical characteristics and survival outcomes of patients with perforated gastric cancer (GC) according to the surgical treatment approach. We found that perforated GC (PGC) is a rare but severe complication of GC, associated with high hospital mortality. It occurred more frequently in patients with advanced-stage disease, particularly stages III and IV. Surgical management varied, including one-stage gastrectomy, primary perforation repair, or a two-stage strategy—initial closure followed by delayed gastrectomy. Among these, overall survival was significantly higher in patients who underwent gastrectomy. Therefore, when clinically feasible, gastrectomy—either immediate or staged—should be considered the preferred approach, as it confers a survival advantage over perforation repair alone in the context of PGC.
