METZ, France — Peter Sagan of Slovakia avoided a bloody, across-the-road pileup to capture a stage for the third time at the Tour de France on Friday while Fabian Cancellara of Switzerland also steered clear of the mayhem to keep the yellow jersey.
The 129-mile ride from Epernay to Metz began in the Champagne region of France, with roadside fans holding aloft glasses of bubbly to cheer the riders.
But as the pack picked up speed to chase four breakaway riders with about 16 miles to go, at least two dozen riders spilled across a rural road. Many were downed and dazed, looking for team staffers in a jumble of injured riders and bikes.
"It was like a trench hit by a (grenade) when I entered the crash to give my bike to Bauke," Rabobank's Laurens Ten Dam said on Twitter, referring to teammate Bauke Mollema. "Lots of blood and screaming. Carnage."
The U.S. Garmin-Sharp team bore the brunt of the crash.
Tom Danielson, who finished in last year's Tour in eighth place, was already nursing a separated shoulder from a crash earlier in the week. In Friday's spill, he was briefly knocked unconscious, and later rushed to a hospital for hip, collarbone and elbow injuries. He was one of at least four riders to drop out of the race because of the crash.
"It was the scariest crash I've ever been in," Garmin veteran David Millar said. He had black marks of chain-grease all over his arm and said the riders were going at least 43 mph at the time.
"God knows how it happened," Millar said.
Garmin's Ryder Hesjedal of Canada — winner of the Giro d'Italia in May — injured his knee and lost more than 13 minutes, all but ending his chances for a top-three finish. He had started the stage in ninth place, 18 seconds back.
RadioShack leader Frank Schleck of Luxembourg, who was third in last year's Tour, said he had pain in his hip, elbow and shoulder and that team tactics may need to be revised for Saturday. Two other contenders, Bradley Wiggins and defending champion Cadel Evans, escaped unscathed.
A Tour medical report listed 27 riders as injured on the day — two hospitalized from the first crash, and eight from the second. Aside from Danielson, Tour officials listed the other dropouts as Mikel Astarloza of Eustaltel-Euskadi, Davide Vigano of Lampre and Wouter Poels of Vacansoleil.
The casualty count continued into the evening. A Rabobank team spokesman said Maarten Wynants had pulled out with two broken ribs and a punctured lung. Katusha said three-time world champion Oscar Freire had a broken rib, becoming at least the sixth rider to drop out.
The one-day tally eclipsed the four withdrawals due to either crashes or illness across six previous days in total.
Overall, Cancellara leads ahead of Wiggins — a pre-race favorite hoping to become the first Briton to win the Tour — by seven seconds. Evans climbed one spot to sixth, and is now 17 seconds back, after Edvald Boassen Hagen of Norway lost more than two minutes in a crash.
The main pack, led by sprint teams from Orica-GreenEdge and Lotto-Belisol, then caught four breakaway riders with just over a mile to go. Andre Greipel of Germany, who is hoping for a third consecutive stage win, was the first to make a move in the final section, but couldn't resist Sagan's surge.
"I was in a good position, I kept it and then nothing hampered my effort," Sagan said. "I took Greipel's wheel and everything went according to plan."
Garmin had one bright spot: U.S. rider David Zabriskie launched an attack 3 miles after the start, and was joined by three other riders.
The four breakaway riders worked well together and built a four-minute lead over the main pack before Cancellara's teammates moved to the front to set a faster tempo.
But the day's first crash 22 miles into the stage that involved at least 20 riders upset the chase, and the escapees' advantage grew to more than six minutes after 26 miles.
Among those caught in that crash were Rabobank team leader Robert Gesink, winner of the Tour of California this year, and former Spanish Vuelta champion Alejandro Valverde of Spain. But all the riders involved in the pileup to have gotten back on their bikes.
Another minor crash slowed the pack with 37 miles to go, with Greipel hitting the ground.
Zabriskie, who earned honors as the stage's most competitive rider — held out alone leading the breakaway until sprinters from the depleted front pack overtook him.
The race moves into the mountains Saturday with a 123-mile ride to the ski resort of La Planche des Belles Filles in the Vosges.
Associated Press writers Greg Keller and Samuel Petrequin contributed to this report.