PurposeTo identify the potential therapeutic role of postoperative radiotherapy (RT) in patients with locally advanced (stage II and stage III) gastric signet ring cell carcinoma (SRC).Materials and methodsPatients with locally advanced gastric SRC from the Surveillance, Epidemiology, and End Results program database between 2004 and 2012 were included in our study. Univariate and multivariate Cox proportional models were performed, and survival curves were generated to evaluate the prognostic effect of postoperative RT and surgery alone on SRC patients. Propensity score matching (PSM) was used to avoid selection bias among the study cohorts.ResultsWe found that patients with postoperative RT had better probability of survival compared with those who did not receive RT (overall survival [OS], P<0.001; cancer-specific survival [CSS], P<0.001). After PSM, analysis of both overall and CSS showed that patients who underwent postoperative RT had better prognosis than those receiving surgery alone in the matched cohort (OS, P=0.00079; CSS, P=0.0036). Multivariate Cox proportional model indicated that postoperative RT had better effect on prognosis compared with surgery alone with respect to both overall (hazard ratio [HR], 0.716; 95% confidence interval [95% CI], 0.590–0.87; P=0.001) and CSS (HR, 0.713; 95% CI, 0.570–0.890; P=0.003).ConclusionsPostoperative RT had better prognosis compared with surgery alone for both overall and CSS for patients with locally advanced gastric SRC.

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Background: N6-methyladenosine (m 6 A) RNA methylation regulators have been implicated in the carcinogenesis and progress of a variety of cancers. Until now, the effects of them on intrahepatic cholangiocarcinoma (ICC) have been poorly understood. Methods: We used the GEO databases to systematically evaluate the expression profiles of 36 m 6 A RNA methylation regulators in ICC patients and produced a signature to assess its prognostic values. In vitro experiments were implemented to confirm the expression level. Results: Compared to normal intrahepatic bile duct tissues, more than half of these 36 genes showed different levels of expression in ICC tissues. Two groups emerged from the consensus cluster analysis of these 36 genes. The two cluster of patients had significantly different clinical outcomes. In addition, we created a m 6 A-related prognostic signature that performed exceptionally well in the prognostic categorization of ICC patients, based on the ROC curves, Kaplan-Meier curves, and univariate and multivariate Cox regression analyses. Further research showed that there was a significant association between the m 6 A-related signature and the manifestations of tumor immune microenvironment in ICC. The expression level and biological effect of METTL16, one of the two m 6 A RNA methylation regulators incorporated in the signature, were confirmed and explored by using in vitro experiments. Conclusions: This analysis revealed the predictive roles of m 6 A RNA methylation regulators in ICC.

Background Lymph node status has a strong predictive effect on the prognosis of all patients with gastric cancer. It is unclear whether the positive lymph node ratio (PLNR) is a reliable prognostic factor for gastric signet ring cell carcinoma (SRCC). Methods Patients with SRCC were obtained from the Surveillance, Epidemiology and End Results (SEER) database for the years 1998–2013. Cutoff values of positive lymph node ratio (PLNR) were decided using X-tile program. Survival was determined using the Kaplan-Meier method. Univariate and multivariate analyses were used to identify prognosticator of gastric signet ring cell carcinoma. Results A total of 1,884 cases were identified. 0.8 as the optimal cutoff value to separate the patients into high and low risk subsets in accordance of cancer-caused survival in SRCC patients (the number as 0.8, P<0.0001). Patients with PLNR >0.8 remained to have a poorer prognosis compared with those with PLNR <0.8 as shown by both OS (HR =2.083, 95% CI: 1.862–2.33, P<0.001) and CSS (HR =2.052, 95% CI: 1.802–2.336, P=0.014) in the multivariate cox regression model. Conclusions PLNR is of great significance in the evaluation of prognosis for patients with SRCC.