Clinical Characteristics and Outcomes of Patients with Primary Signet-Ring Cell Carcinoma of the Urinary Bladder

Abstract

Objective: The aim of this study was to examine the epidemiology, natural history, treatment pattern and predictors of long-term survival of patients with signet-ring cell carcinoma (SRCC) of the urinary bladder based on the analysis of the national Surveillance, Epidemiology, and End Results (SEER) database. Methods and Results: In total, 230 patients with pathologically confirmed SRCC of the urinary bladder were identified between 1973 and 2004. The mean age was 65 ± 13 years. Overall, 75.7% of the patients had a poorly differentiated or undifferentiated histology grade, 26.5% presented with metastatic disease, 59 (25.7%) underwent transurethral resection for bladder tumor only and 107 (46.5%) had partial or radical cystectomy. The 1-, 3- and 10-year cancer-specific survival rates were 66.8, 40.6 and 25.8%, respectively. Using multivariable Cox proportional hazard model, age (HR 1.024; p = 0.004), stage (distant vs. local, HR 6.2; p < 0.001) and cystectomy (HR 0.53; p = 0.002) were identified as independent predictors for cancer-specific survival. Conclusions: Receipt of cystectomy was strongly associated with improved survival in the patients with SRCC of urinary bladder. However, many patients with localized tumors did not receive potentially curative cystectomy. Further studies to address the barriers to the delivery of appropriate care to these patients are warranted.

Signet-Ring Cell Carcinoma as an Independent Prognostic Factor for Patients With Urinary Bladder Cancer: A Population-Based Study

“…The proportion of the SRCC component is associated with advanced-stage disease and worse outcomes. Its invasion pattern could spread laterally and widely without protruding through the surface (18). Cystoscopy might only reveal edematous, bullous, or erythematous mucosa (19).…”

“…However, the SEER database does not provide information on chemotherapy, which was an obvious weakness of our study. Although some studies found that SRCC was resistant to systematic chemotherapy based on small sample sizes (18), some recent studies reported that adjuvant chemotherapy may be a potential component of effective treatment (21,22). Checkpoint-inhibitor drugs and genomic research offer hope to improve the treatment of bladder cancer (23).…”

Contemporary rates of pathological features and mortality for adenocarcinoma of the urinary bladder in the USA

“…Based on the established concept of aggressiveness in the SRC ADK variant, we also tested for the effect of this histological subtype on CSM . Here, we showed that an important (31%) proportion of patients with ADK harbor SRC histology, a subtype known for its poor prognosis .…”

“…[22][23][24][25][26] Here, we showed that an important (31%) proportion of patients with ADK harbor SRC histology, a subtype known for its poor prognosis. [23][24][25][26] These patients had higher rates of NOC at RC, and also had worse CSM rates than other (non-SRC) ADK patients, and by extension UC patients. Conversely, non-SRC ADK histological subtype did not result in higher NOC rates or worse prognosis than UC.…”

Signet-Ring-Cell Carcinoma of Stomach Metastatic to the Bladder

“…[15][16][17] However, very recently, some authors reported a large series of patients with primary SRC carcinoma of the urinary bladder, underlining potentially curative cystectomy for these patients. 18 To plan the appropriate therapeutic strategy, a differential diagnosis between primary bladder adenocarcinoma and secondary adenocarcinoma from other primary sites is mandatory. Nevertheless, this differential diagnosis is often difficult and supported by few features.…”