Gertsch et al reported their experience with the management of gastric cancer perforation and intended to identify a highrisk group. Free perforation of gastric cancer is not a common experience. Rather, it is common in a gastric ulcer. Recently, I have encountered only four cases of free perforated gastric cancer among 2434 cases (from January 1991 to November 1994). This trend probably is occurring because gastric cancer is detected earlier than before. Because surgical treatment for gastric cancer is different from that for benign ulcer, I strongly believe that frozen-section study of the perforated lesion is necessary to provide proper surgical management. For benign ulcer, I usually do not resect the stomach. 1 perform gastric resection for perforated gastric cancer as long as the patient's condition is tolerable. According to data on the treatment given to 312 patients with stomach cancer at city district hospitals in St Petersburg, Russia, the
Kim J. Invited Commentary. Arch Surg. 1995;130(2):181. doi:10.1001/archsurg.1995.01430020071012
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