Clinicopathological Characteristics and Prognosis of Signet Ring Gastric Cancer: A Population-Based Study

Abstract

BackgroundTo better define the clinicopathologic characteristics of signet ring cell (SRC) gastric cancer and build a prognostic model for it.MethodsSRC patient information from 2010 to 2015 were identified using Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier method and log-rank test were used to estimate Overall survival (OS) and to determine associations with histologic subtypes. In COX proportional hazards regression model–based univariate and multivariate analyses, significant variables for construction of a nomogram were screened out. The nomogram was validated by means of the concordance index (CI), calibration plots, and receiver operating characteristics (ROCs) curves.ResultsA total of 11,363 gastric cancer patients were enrolled. On dividing the patients into SRC, well-to-moderately differentiated (WMD) adenocarcinoma, and poorly differentiated (PD) adenocarcinoma, differences among these subgroups emerged. SRC patients were more likely to occur in female and young patients than other histologic subtypes. Larger tumors, stage T4, and node stage N3 were more likely to be found in the SRC group. The survival for SRC patients was better than non-SRC patients in stage I. Univariate and multivariate analyses identified age, tumor site, larger tumor size, advanced T classification, advanced N classification, advanced TNM stage, and surgery of primary site as independent prognostic indicators. Then an OS nomogram was formulated.ConclusionsSRC had distinct clinicopathological characteristics. The nomogram provided an accurate tool to evaluate the prognosis of SRC.

Gastric Signet Ring Cell Carcinoma: An Overview

“…al show that GSRCC occurs more frequently in the middle and lower stomach region and that GSRCC is more likely to have bone metastasis (in comparison to other gastric cancers, which tend to have liver and lung metastasis). Importantly, the study found that signet ring cancer cell histology is not independently associated with mortality when disease stage is controlled for, in which case signet ring cell carcinoma is not more aggressive than differentiated cancers (32).…”

“…Another recent study reevaluates GSRCC clinicopathological data (32) in order to attempt to clarify some of the more controversial findings, including some of those discussed in this text. The study brings solid evidence to further support that there are distinct features that separate GSRCC from gastric adenocarcinoma.…”

“…The study brings solid evidence to further support that there are distinct features that separate GSRCC from gastric adenocarcinoma. Moreover, independent prognostic factors are inferred: age, T stage, N stage, surgery, tumor size and tumor site (32). Being independent, these factors are effectively employed into the design of a nomogram for predicting overall survival with high accuracy.…”

Clinicopathological characteristics and prognosis of gastric signet ring cell carcinoma

“…GSRC tended to occur in young and female patients, which was consistent with previous studies[ 9 ]. Although gastric cancer was considered to be a disease more frequently seen in men, a large number of studies had shown that the incidence of GSRC in women was higher[ 13 ]. At the same time, the age of onset of GSRC was significantly earlier than that of gastric adenocarcinoma.…”

“…Studies have showed that the prognosis of early SRC is good, while the prognosis of advanced stage SRC is poor[ 9 , 12 ]. Most recently, abundant evidence in the United States suggested that GSRC was not necessarily a risk factor affecting prognosis[ 13 ]. Combination of postoperative adjuvant radiotherapy, chemotherapy, and targeted therapy had an excellent effect in improving the survival rate of gastric cancer patients.…”