Clinicopathological factors and survival outcomes of signet-ring cell and mucinous carcinoma versus adenocarcinoma of the colon and rectum: a systematic review and meta-analysis

Fadel, Michael G; Malietzis, George; Constantinides, Vasilis; Pellino, Gianluca; Tekkis, Paris; Kontovounisios, Christos

doi:10.1007/s12672-021-00398-6

Cited by 17 publications

(8 citation statements)

References 61 publications

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“…Therefore, lymphovascular invasion is closely related to the features of aggressive tumours. While our study showed a trend towards poorer survival with all colorectal adenocarcinomas associated with lymphovascular invasion, our findings have clinical relevance in that it suggests that the presence of lymphovascular invasion is an indication for more extensive resection of the colorectal tumour [53,54,55].…”

Section: Discussionsupporting

confidence: 37%

Survival Outcomes of Histopathological Subtypes of Colorectal Adenocarcinoma in Ugandan Patients

Wismayer

Kiwanuka

Wabinga

et al. 2021

JAMMR

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Background: High grade mucinous adenocarcinomas have been found to be more common in younger patients and are associated with a poor prognosis in the West. In Uganda, survival outcomes of the different histopathologic subtypes of colorectal adenocarcinoma (CRC) and lymphovascular invasion (LVI) is unknown. We determined the survival outcome of the different histopathologic subtypes of CRC and LVI among Ugandan patients. Methods: A retroprospective cohort study on patients diagnosed with CRC from 2008 to 2018 were identified from the Kampala Cancer Registry and hospital medical records. Retrieved data included date of diagnosis, demographics, stage, grade and location of CRC. Our outcome was survival, and the main predictor variables were the histopathologic subtype, stage, grade and LVI. We plotted Kaplan-Meier curves for survival, tested the equality of survival by log-rank tests and used multivariable Cox regression to determine factors associated with survival. Results: 12.4% patients predominantly had mucinous adenocarcinoma/signet ring colorectal carcinoma (MAC/SRCC) and 87.6% patients had classical adenocarcinoma (AC). The median age (SD) at diagnosis of MAC/SRCC was 47.8 (16.6) years and 53.8 (15.9) years for AC. SRCC/MAC was significantly associated with more LVI than AC (p=0.002). In multivariate analysis, factors associated with increased mortality included stage III (aHR=2.56; p=0.009) and stage IV (aHR=6.64; p <0.001). After adjusting for lymph node involvement and metastasis, SRCC/MAC patients had a shorter survival than AC patients; however, this difference was not statistically significant (p=0.229). Conclusions: In Uganda, the proportion of MAC is similar to that found in the Western world. SRCC/ MAC were associated with more LVI than AC. SRCC/MAC showed a tendency towards decreased overall survival. In Uganda, more patients present with advanced-stage CRC which was associated with poor survival hence national screening guidelines are necessary to improve survival.

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Section: Discussionsupporting

confidence: 37%

Survival Outcomes of Histopathological Subtypes of Colorectal Adenocarcinoma in Ugandan Patients

Wismayer

Kiwanuka

Wabinga

et al. 2021

JAMMR

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“…In recent years, the survival of patients with CRC has gradually improved with the continuous update of examination and treatment methods. Colorectal signet-ring cell carcinoma (SRCC) is a rare tumor type, accounting for approximately 1% of all CRC [ 2 , 3 ]. Histologically, colorectal SRCC is characterized by the presence of nuclei that are crescent-shaped and resemble rings, hence the name, which are off-centered in over 50% of tumor cells [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Prognostic and predictive value of tumor deposits in advanced signet ring cell colorectal cancer: SEER database analysis and multicenter validation

Li,

Liu,

Feng

et al. 2024

World J Surg Onc

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Background Colorectal signet-ring cell carcinoma (SRCC) is a rare cancer with a bleak prognosis. The relationship between its clinicopathological features and survival remains incompletely elucidated. Tumor deposits (TD) have been utilized to guide the N staging in the 8th edition of American Joint Committee on Cancer (AJCC) staging manual, but their prognostic significance remains to be established in colorectal SRCC. Patients and methods The subjects of this study were patients with stage III/IV colorectal SRCC who underwent surgical treatment. The research comprised two cohorts: a training cohort and a validation cohort. The training cohort consisted of 631 qualified patients from the SEER database, while the validation cohort included 135 eligible patients from four independent hospitals in China. The study assessed the impact of TD on Cancer-Specific Survival (CSS) and Overall Survival (OS) using Kaplan-Meier survival curves and Cox regression models. Additionally, a prognostic nomogram model was constructed for further evaluation. Results In both cohorts, TD-positive patients were typically in the stage IV and exhibited the presence of perineural invasion (PNI) (P < 0.05). Compared to the TD-negative group, the TD-positive group showed significantly poorer CSS (the training cohort: HR, 1.87; 95% CI, 1.52–2.31; the validation cohort: HR, 2.43; 95% CI, 1.55–3.81; all P values < 0.001). This association was significant in stage III but not in stage IV. In the multivariate model, after adjusting for covariates, TD maintained an independent prognostic value (P < 0.05). A nomogram model including TD, N stage, T stage, TNM stage, CEA, and chemotherapy was constructed. Through internal and external validation, the model demonstrated good calibration and accuracy. Further survival curve analysis based on individual scores from the model showed good discrimination. Conclusion TD positivity is an independent factor of poor prognosis in colorectal SRCC patients, and it is more effective to predict the prognosis of colorectal SRCC by building a model with TD and other clinically related variables.

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“…Signet-ring cell carcinomas are observed in approximately 1% of colorectal carcinoma cases and are present as single cells with abundant cytoplasmic mucin. Mucinous adenocarcinomas with signet-ring cell carcinomas are distinctively different from adenocarcinoma in tumor biology, with an aggressive phenotype[ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Local recurrence after successful endoscopic submucosal dissection for rectal mucinous mucosal adenocarcinoma: A case report

Murakami¹,

Tanabe²,

Ono³

et al. 2023

World J Gastrointest Oncol

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BACKGROUND Mucinous adenocarcinoma of the colorectum is a rare histological subtype characterized by an abundant mucinous component. Mucinous tumors are frequently diagnosed at an advanced stage, which indicates an aggressive subtype. However, few case reports have been published, and little information is available concerning genetic alterations in mucinous adenocarcinoma. CASE SUMMARY A 76-year-old man underwent en bloc endoscopic submucosal dissection (ESD) for the management of a type 0-Is+IIa lesion. Histological examination revealed an intramucosal mucinous adenocarcinoma with signet-ring cell carcinoma and well-to-moderately differentiated tubular adenocarcinoma. Three years after the ESD, local recurrence was detected by an endoscopic examination, revealing a new 0-Is+IIa lesion with a phenotype similar to the previously resected lesion. Re-ESD was chosen for the management of the recurrent tumor, and the histological examination showed positive tumor infiltration at the vertical margin. Additional surgical resection was performed for the curative treatment. Genetic analysis showed pathogenic alterations in RNF43 and TP53 in the adenoma and an additional SMAD4 alteration in the carcinoma. CONCLUSION This mucinous mucosal adenocarcinoma case was suggested to have an aggressive phenotype and a careful and close follow-up are required.

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Clinicopathological factors and survival outcomes of signet-ring cell and mucinous carcinoma versus adenocarcinoma of the colon and rectum: a systematic review and meta-analysis

Cited by 17 publications

References 61 publications

Survival Outcomes of Histopathological Subtypes of Colorectal Adenocarcinoma in Ugandan Patients

Survival Outcomes of Histopathological Subtypes of Colorectal Adenocarcinoma in Ugandan Patients

Prognostic and predictive value of tumor deposits in advanced signet ring cell colorectal cancer: SEER database analysis and multicenter validation

Local recurrence after successful endoscopic submucosal dissection for rectal mucinous mucosal adenocarcinoma: A case report

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