A 10-Year Outcomes Evaluation of Mucinous and Signet-Ring Cell Carcinoma of the Colon and Rectum

Kang, Hakjung; O’Connell, Jessica; Maggard, Melinda A.; Sack, Jonathan; Ko, Clifford Y.

doi:10.1007/s10350-004-0932-1

Cited by 282 publications

(321 citation statements)

References 21 publications

(19 reference statements)

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“…The reported 5-year survival in the literature is 9-37%, [1][2][3][4][5][6][7][8][9][10] which is comparable to the 33% survival in this study. The literature contains limited data on the molecular features of signet ring cell carcinoma.…”

Section: Discussionsupporting

confidence: 84%

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Loss of heterozygosity, aberrant methylation, BRAF mutation and KRAS mutation in colorectal signet ring cell carcinoma

et al. 2012

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The relationship of molecular abnormalities with clinicopathologic features and survival in colorectal signet ring cell carcinoma, and its comparison with mucinous and conventional adenocarcinomas, has not been well studied. High-level microsatellite instability, loss of heterozygosity (LOH) at four loci, CpG island methylation phenotype based on seven loci, BRAF V600E mutation and KRAS mutation in signet ring cell carcinoma were compared with mucinous and conventional adenocarcinomas. The relationship of these molecular features in signet ring cell carcinoma with clinicopathologic features and survival was examined. LOH was observed in 93% of signet ring cell carcinomas compared with 62 and 70% of mucinous and conventional adenocarcinomas. Also, 80% of signet ring cell carcinomas with high-level microsatellite instability showed LOH compared with 14% each of mucinous and conventional adenocarcinomas. High-level microsatellite instability, CpG island methylation phenotype-positive status and BRAF V600E mutation were more often seen in signet ring cell carcinoma and mucinous adenocarcinoma compared with conventional adenocarcinoma. BRAF V600E mutation was significantly associated with CpG island methylation phenotype-positive status. Stage and BRAF V600E mutation in microsatellite-stable cases were the only variables with an affect on survival. In conclusion, chromosomal instability manifested by LOH is nearly a universal finding in signet ring cell carcinoma, including cases with highlevel microsatellite instability. This may explain the aggressive behavior of signet ring cell carcinoma irrespective of high-level microsatellite-instability status. BRAF V600E mutation and CpG island methylation phenotypepositive status are similar in signet ring cell carcinoma and mucinous adenocarcinoma but more frequent when compared with conventional adenocarcinoma. In signet ring cell carcinoma, BRAF V600E mutation adversely affects survival in microsatellite-stable tumors, but not in high-level microsatellite-unstable tumors. The high frequency of methylation and BRAF V600E mutation suggests that many signet ring cell carcinomas may be related to the serrated pathway of carcinogenesis.

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Section: Discussionsupporting

confidence: 84%

“…[1][2][3][4][5][6][7][8][9][10] By definition, 450% of tumor cells have signet ring cell morphology. 11 Signet ring histology is considered an independent adverse prognostic factor by the American Joint Committee on Cancer and the College of American Pathologists.…”

mentioning

confidence: 99%

Loss of heterozygosity, aberrant methylation, BRAF mutation and KRAS mutation in colorectal signet ring cell carcinoma

et al. 2012

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“…On the other hand, other studies did not confirm the worse prognosis in patients with MA compared to NMA of the colon [19,24]. An analysis from the National Cancer Database showed inferior OS in MA of the rectum but not of the colon [9].…”

Section: Discussionmentioning

confidence: 92%

“…According to Simonds et al and Umpleby et al, mucin should constitute at least 60% of the colonic cancer specimen to be labeled as MA [16,17], while a cutoff level of 50% is being used in WHO classification [18]. This difference in cutoff value may explain the higher incidence of MA in the western countries compared to those in Asia [16,19]. Many studies showed that patients with MA of the rectum had worse prognosis in terms of RFS and OS compared to non-mucinous adenocarcinoma (NMA) [9,19,20].…”

Section: Discussionmentioning

confidence: 99%

“…This difference in cutoff value may explain the higher incidence of MA in the western countries compared to those in Asia [16,19]. Many studies showed that patients with MA of the rectum had worse prognosis in terms of RFS and OS compared to non-mucinous adenocarcinoma (NMA) [9,19,20]. On the other hand, the prognostic significance of MA of the colon is yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

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Factors associated with short recurrence-free survival in completely resected colon cancer

Alnimer

Ghamrawi

Aburahma

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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Background: Several factors could affect disease recurrence in surgically resected colon cancer. While the role of certain factors such as cancer stage and grade is well established, the role of other factors (e.g., histological subtypes) is yet to be determined. Objective:Therefore, we conducted a study to evaluate the impact of several factors in recurrence-free survival (RFS) in patients who were disease free following surgical resection of the colon cancer. Design/Methods: Data were collected for patients with Stage I–III colon cancer who underwent complete surgical resection of the tumor between January 2010 and December 2015 in our institution. A total of 90 subjects met the inclusion criteria and were included in the study. The following factors were collected at the time of surgical resection of the colonic tumor: patient’s age, gender, colon cancer stage, grade and histological subtype, body mass index, hemoglobin A1c, and smoking history. Results: A total of 28 patients (31%) developed recurrence and had a mean follow-up time of 19.8 months (range: 2–54.4 months). Median RFS was 54.4 months with a 5-year RFS of 49%. Advanced colonic cancer stage and mucinous histological subtype were associated with shorter RFS with an HR of 2.37, 95% CI = 1.38–4.06, and 95% CI = 1.02–5.90, respectively. Current smokers or those who quit less than 15 years earlier tended to have worse RFS with an HR of 2.47, 95% CI = 0.98–6.27. Conclusion: Advanced colon cancer stage and mucinous histological subtype are independent risk factors for cancer recurrence and shorter RFS in completely resected colonic tumor.

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MicroRNA Expression Profiles Associated With Prognosis and Therapeutic Outcome in Colon Adenocarcinoma

Schetter

Leung

Sohn

et al. 2008

JAMA

1,387

1,247

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A 10-Year Outcomes Evaluation of Mucinous and Signet-Ring Cell Carcinoma of the Colon and Rectum

Cited by 282 publications

References 21 publications

Loss of heterozygosity, aberrant methylation, BRAF mutation and KRAS mutation in colorectal signet ring cell carcinoma

Loss of heterozygosity, aberrant methylation, BRAF mutation and KRAS mutation in colorectal signet ring cell carcinoma

Factors associated with short recurrence-free survival in completely resected colon cancer

MicroRNA Expression Profiles Associated With Prognosis and Therapeutic Outcome in Colon Adenocarcinoma

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