Characteristics and prognostic factors of colorectal mucinous adenocarcinoma with signet ring cells

Abstract

BackgroundColorectal signet ring cell (SRC) carcinoma occurs rarely with a poor prognosis. The present study assessed the prognostic factors and predictive value of SRC ratio in colorectal mucinous adenocarcinoma (MAC) with SRCs (MAC-SRC).Patients and methodsA total of 95 consecutive colorectal MAC-SRC patients, confirmed pathologically from February 1987 to December 2015, were analyzed retrospectively in our institute. Clinical characteristics, pathological grade, TNM staging, and SRC ratio were assessed to identify the prognostic factors related to progression-free survival (PFS) and overall survival (OS). SPSS 22.0 was used for statistical analyses.ResultsThe median follow-up time was 29.7 months (range 0.8–165). Meanwhile, 5-year PFS and OS rates were 25.6% (95% confidence interval [CI] 16.192–35.008%) and 40.5% (95% CI 29.524–51.476%), respectively. Among the 81 patients who underwent surgery, 78 (96.3%) were diagnosed as stage T3 or T4; 74 (91.4%) showed lymph node involvement, and 27 (29.3%) presented distant metastasis. Metastases of the peritoneal cavity and ovaries were observed commonly in colorectal MAC-SRC. In the multivariate Cox regression model, SRC ratio ≥35%, absence of preoperative radiotherapy, and distant metastasis were independent predictors of PFS. Furthermore, SRC ratio ≥35%, absence of preoperative chemotherapy (pre-CT), and distant metastasis were independent risk factors for poor prognosis.ConclusionA long-term follow-up of colorectal MAC-SRC reveals that it is a rare subtype of colorectal MAC with a dismal prognosis. Furthermore, SRC ratio, pre-CT, and M stage seem to affect OS independently.

Predictive Factors of Positive Circumferential and Longitudinal Margins in Early T3 Colorectal Cancer Resection

“…In the previous studies [ 29 , 30 ], it has been established that mucinous and signet ring types of CRC have a worse prognosis compared to other varieties of CRC. They are characterized by being prevalent in more advanced stages of the disease, with a much higher rate of lymphatic metastasis, serous infiltration, and peritoneal dissemination.…”

Predictors of Long-Time Survivors in Nonmetastatic Colorectal Signet Ring Cell Carcinoma: A Large Population-Based Study

“…Colorectal SRCC is a rare subtype of CRC, which consists of 0.1% to 2.6% of all CRC cases [6,15]. Previous studies have revealed a female predominance in colorectal SRCC [16,17], which is similar with that of gastric SRCC. Moreover, a younger age of onset has been reported in colorectal SRCC than differentiated colorectal adenocarcinoma [18,19].…”

Prognostic Value of KRAS Gene Mutation on Survival of Patients with Peritoneal Metastases of Colorectal Adenocarcinoma

“…This type of tumour shows a particular tendency to peritoneal dissemination and resistance to current drugs [ 14 ]. In our study, we have grouped tumours with signet ring histopathology and other mucinous tumours together due to the small sample size analysed, although it is known that the outcome of signet ring cell is worse [ 15 ]. A high ECOG score was associated with poorer survival.…”