Publication Name	World Journal of Gastroenterology
Manuscript ID	119719
Country	Italy

Category	Oncology
Manuscript Type	Retrospective Study
Article Title	Alarm from the peritoneum: Gastrointestinal perforations in cancer patients, with a focus on perforations of unknown origin
Manuscript Source	Unsolicited Manuscript
All Author List	Manlio Monti, Bianca Ceredi, Nicolò Paganelli, Roberto Vespignani, Alice Andalò, Paolo De Angelis, Nicola Gentili, Ilaria Massa, Andrea Roncadori, Valentina Danesi and William Balzi
Funding Agency and Grant Number	Funding Agency Grant Number Ricerca Corrente by the Italian Ministry of Health
Corresponding Author	Valentina Danesi, PhD, Outcome Research, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, Meldola 47014, Emilia-Romagna, Italy. valentina.danesi@irst.emr.it
Key Words	Gastrointestinal perforation; Spontaneous perforation; Cancer patients; Prognostic factors; Emergency surgery; Overall survival; Real-world evidence
Core Tip	In this single-center retrospective study, a small but clinically relevant subset of gastrointestinal perforations occurred without an identifiable cause. Patients with perforation of unknown origin showed distinctive clinical and pathological features compared with cancer-related and cancer-unrelated cases, including a higher burden of comorbidities, particularly arterial hypertension, a different distribution of primary tumors (lung and kidney cancers), and preferential involvement of the colon and small intestine. Although outcomes appeared broadly comparable across groups, these findings suggest that patient-related factors may contribute to spontaneous perforation, highlighting an under-recognized clinical scenario in oncology practice.
Citation	Monti M, Ceredi B, Paganelli N, Vespignani R, Andalò A, De Angelis P, Gentili N, Massa I, Roncadori A, Danesi V, Balzi W. Alarm from the peritoneum: Gastrointestinal perforations in cancer patients, with a focus on perforations of unknown origin. World J Gastroenterol 2026; In press

Received	2026-02-05 01:22
Peer-Review Started	2026-02-05 01:27
First Decision by Editorial Office Director	2026-03-03 09:33
Return for Revision	2026-03-03 09:33
Revised	2026-03-16 15:57
Publication Fee Transferred	2026-04-15 13:27
Second Decision by Editor	2026-05-21 02:43
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-05-21 07:51
Articles in Press	2026-05-21 07:51
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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