Clinicopathological Features and Prognostic-Related Risk Factors of Gastric Signet Ring Cell Carcinoma: A Meta-Analysis

Guo, Ying; Wang, Qian; Tian, Qing; Bo, Changwen; Li, Na; Zhang, Sujing; Li, Peishun

doi:10.1155/2022/3473445

Cited by 5 publications

(5 citation statements)

References 54 publications

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“…Nakamura et al suggested that sex, age, tumor location, size, macroscopic type, and TNM stage are independent risk factors for GSRC prognosis [ 23 ]. A meta-analysis by Guo et al [ 24 ] demonstrated that age, lymphatic invasion, and TNM stage were independent risk factors for GSRC prognosis. Additionally, meta-analyses by both Zhao et al [ 25 ] and Zhao et al [ 26 ] indicated that the prognosis of early GSRC patients was better than that of patients with other types of GC, whereas the prognosis of advanced GSRC patients was relatively poor.…”

Section: Discussionmentioning

confidence: 99%

Novel nomogram to predict the overall survival of postoperative patients with gastric signet

et al. 2023

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Background The TNM staging system cannot accurately predict the prognosis of postoperative gastric signet ring cell carcinoma (GSRC) given its unique biological behavior, epidemiological features, and various prognostic factors. Therefore, a reliable postoperative prognostic evaluation system for GSRC is required. This study aimed to establish a nomogram to predict the overall survival (OS) rate of postoperative patients with GSRC and validate it in the real world. Methods Clinical data of postoperative patients with GSRC from 2002 to 2014 were collected from the Surveillance, Epidemiology, and End Results database and randomly assigned to training and internal validation sets at a 7:3 ratio. The external validation set used data from 124 postoperative patients with GSRC who were admitted to the Affiliated Tumor Hospital of Harbin Medical University between 2002 and 2014. The independent risk factors affecting OS were screened using univariate and multivariate analyses to construct a nomogram. The performance of the model was evaluated using the C-index, receiver operating characteristic curve (ROC), calibration curve, decision analysis (DCA) curve, and adjuvant chemotherapy decision analysis. Results Univariate/multivariate analysis indicated that age, stage, T, M, regional nodes optimized (RNE), and lymph node metastasis rate (LNMR) were independent risk factors affecting prognosis. The C-indices of the training, internal validation, and external validation sets are 0.741, 0.741, and 0.786, respectively. The ROC curves for the first, third, and fifth years in three sets had higher areas under the curves, (training set, 0.782, 0.864, 0.883; internal validation set, 0.781, 0.863, 0.877; external validation set, 0.819, 0.863, 0.835). The calibration curve showed high consistency between the nomogram-predicted 1-, 3-, and 5-year OS and the actual OS in the three queues. The DCA curve indicated that applying the nomogram enhanced the net clinical benefits. The nomogram effectively distinguished patients in each subgroup into high- and low-risk groups. Adjuvant chemotherapy can significantly improve OS in high-risk group (P = 0.034), while the presence or absence of adjuvant chemotherapy in low-risk group has no significant impact on OS (P = 0.192). Conclusions The nomogram can effectively predict the OS of patients with GSRC and may help doctors make personalized prognostic judgments and clinical treatment decisions.

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Section: Discussionmentioning

confidence: 99%

Novel nomogram to predict the overall survival of postoperative patients with gastric signet

et al. 2023

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“…Comprehensive risk factors for GC have been identified, which include a set of individual characteristics, lifestyle, genetic, and environmental factors. In this regard, demographic parameters, ethnicity, infection with Helicobacter pylori, smoking, and high-nitrates dietary regimens have been identified as the potential risk profiles for GC (4)(5)(6). The role of genes and the factors coded by them in the occurrence and progression of GC has been thoroughly proven.…”

Section: Introductionmentioning

confidence: 99%

The Role of P21 Protein Expression in Predicting Progression and Biological Behaviors of Gastric Adenocarcinomas

2023

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Background: P21 protein is a cyclin-dependent kinase inhibitor and has a crucial function as a cell cycle regulator in malignant tissues. Thus, its association with aggressive characteristics of malignant lesions is suggested. Objectives: We evaluated the expression level of P21 in gastric cancers and its association with the histopathological findings of cancer. Methods: This cross-sectional study was performed on gastric adenocarcinomas from radical gastrectomy. The histopathological examination was assessed by Hematoxylin & Eosin. The immunohistochemistry technique was then used to assess the expression of the P21 marker. Results: P21 positivity was revealed in 28 specimens of the cancerous lesions with an overall prevalence of 70.0% in our population. There was no association between P21 positivity and tumor-related characteristics, including tumor location, type, grade and stage, as well as the size of the cancerous lesion. P21 positivity could not be related to perineural or lymphovascular invasion of the tumor (P-value > 0.05). Conclusions: In our population, the expression of P21 may not be prognostic or predict tumor biological behavior among patients with gastric adenocarcinomas.

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“…Previous published data have suggested that diffuse-type gastric cancer and the presence of signet-ring cells in tumors might be associated with a lack of response to standard chemotherapy [ 8 , 9 , 10 ]. Signet-ring cell histology has also been described as a poor prognostic factor, particularly in patients with an advanced stage of disease, whereas its role as a prognostic factor in patients diagnosed with early-stage disease is not so well defined [ 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Signet-Ring Cell Histology in the Management of Patients with Non-Metastatic Gastric Cancer: Results from a Retrospective Multicenter Analysis Comparing FLOT Perioperative Chemotherapy vs. Surgery Followed by Adjuvant Chemotherapy

Baleani¹,

Bittoni

Rastelli

et al. 2023

Cancers

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Background: FLOT perioperative chemotherapy represents the standard of care in non-metastatic gastric cancer patients. Signet-ring cell positivity is associated with a worse prognosis in patients with gastric cancer treated with chemotherapy. Comparison between FLOT perioperative chemotherapy vs. surgery followed by adjuvant chemotherapy based on signet-ring cell positivity is lacking. The aim of the analysis was to compare perioperative FLOT with adjuvant chemotherapy in gastric cancer patients stratified by signet-ring cell positivity. Methods: We conducted a retrospective multicenter analysis based on disease-free survival (DFS) and overall survival (OS) in patients with gastric cancer who received perioperative chemotherapy with a FLOT regimen and compared their survival with a historical cohort of patients treated with adjuvant chemotherapy, matched by cT and cN stage and by tumor histological features. Results: Seventy-six patients were enrolled and 24 (32%) were signet-ring cell positive. At a median follow-up time of 39 months, the median DFS was 26.3 months and the median OS was 37.3 months. Signet-ring cell positivity was associated with a shorter OS (median OS: 20.4 vs. 46.9 months, HR: 3.30, 95%CI: 1.56–6.99, p = 0.0018) and DFS (mDFS: 15.2 vs. 38.6 months, HR: 3.18, 95%CI: 1.55–6.54, p = 0.0016). This was confirmed by multivariate analysis for DFS (Exp(B): 2.55) and OS (Exp(B): 2.68). After propensity score matching, statistically significant shorter DFS (HR: 3.30, 95%CI: 1.50–7.35, p = 0.003) and OS (HR: 5.25, 95%CI: 2.18–12–68, p = 0.0002) were observed for patients with signet-ring cell positivity who received perioperative treatment vs. those who received surgery followed by adjuvant chemotherapy. Conclusions: Signet-ring positivity was associated with shorter DFS and OS in patients who received perioperative treatment with FLOT compared with surgery followed by adjuvant therapy. These data suggest that for patients with signet-ring cell histology, FLOT perioperative treatment might not always be the best choice of treatment, and further research should be focused on this group of patients.

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Clinicopathological Features and Prognostic-Related Risk Factors of Gastric Signet Ring Cell Carcinoma: A Meta-Analysis

Cited by 5 publications

References 54 publications

Novel nomogram to predict the overall survival of postoperative patients with gastric signet

Novel nomogram to predict the overall survival of postoperative patients with gastric signet

The Role of P21 Protein Expression in Predicting Progression and Biological Behaviors of Gastric Adenocarcinomas

Impact of Signet-Ring Cell Histology in the Management of Patients with Non-Metastatic Gastric Cancer: Results from a Retrospective Multicenter Analysis Comparing FLOT Perioperative Chemotherapy vs. Surgery Followed by Adjuvant Chemotherapy

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