Is There a Role for Preoperative Chemoradiation in Esophageal Signet Ring Cell Adenocarcinomas?

Gronnier, Caroline; Bekkar, Sarah; Messager, Mathieu; Piessen, Guillaume; Mariette, C.

doi:10.1016/j.athoracsur.2014.11.031

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…It is important to note that, although no information on surgical margins was available in this study, previous studies have shown that SRC has a higher R1/R2 resection rate, a higher number of positive lymph nodes, and is independently associated with a poorer prognosis (6,9,(11)(12)(13)22). Our study corroborates these findings and seems to be consistent with the early trend of SRC requiring surgery combined with adjuvant therapy.…”

Section: Discussionsupporting

confidence: 91%

“…A study that included patients with both SRC and mucinous histology suggested that preoperative chemoradiotherapy had a favorable outcome (18). Notably, the SRC type does not seem to respond significantly to neoadjuvant therapy (12)(13)(14), as 88.2% of patients with SRC showed minimal or no pathological response and only 27.8% were downstaged (10). However, other studies have shown that neoadjuvant chemoradiotherapy has a better prognosis than neoadjuvant chemotherapy, with no statistically significant difference in complete response rates (9,11,22).…”

Section: Discussionmentioning

confidence: 99%

“…Although SRC has been found in a variety of organs in the human body, including the breast, lung, and bladder (6), the upper digestive tract is still a common site of occurrence, with the incidence of esophageal SRC reported to be less than 10% (7,8). Through many small-scale studies, it has been found that esophageal SRC has poor pathomorphological characteristics, and is often staged late, is insensitive to neoadjuvant therapy, has a high positive surgical margin rate, and has a poor prognosis (6,(8)(9)(10)(11)(12)(13)(14), and endoscopic resection for early esophageal SRC appears to be less effective (15). These characteristics have brought great challenges to treatment.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparative analysis of clinical, treatment, and survival characteristics of signet ring cell and adenocarcinoma of esophagus

Zhang¹,

Li²,

Zeng³

et al. 2021

J Gastrointest Oncol

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Background: Signet ring cell carcinoma (SRC) is a rare pathological subtype of mucinous adenocarcinoma (AC). Clinical features, prognosis, and especially treatment methods between SRC and AC of the esophagus remain controversial. Thus, we conducted this study to explore the differences in clinicopathological characteristics and treatment modalities between SRC and AC of the esophagus.Methods: A retrospective cohort study based on the Surveillance, Epidemiology, and End Results (SEER) program database was conducted. Patients diagnosed with SRC or AC not otherwise specified (NOS) were selected between 2004 and 2018. We investigated the prognosis of SRC and AC in terms of overall survival (OS). A subgroup analysis was performed according to the stage and different treatment methods.Results: A total of 24,987 patients were enrolled, including 1,147 with SRC and 23,840 with AC. In the multivariate Cox analysis of the whole cohort, SRC, tumor site, differentiation, metastases, American Joint Committee on Cancer (AJCC) 6th edition staging, treatment, tumor size, lymph nodes examined, and positive lymph nodes were independent risk factors. The results of the subgroup analysis showed that surgery alone was associated with better OS for AC at the early stage, but was not significantly different for SRC (P=0.896). Surgery plus adjuvant therapy was the best treatment for SRC and AC at the late stage. In the multivariate Cox analysis, the treatment of surgery plus adjuvant therapy had a tendency towards better OS at the early stage [hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.39-1.1, P=0.08].Conclusions: SRC is an independent risk factor, with a higher grade of differentiation, later stage, larger tumor size, more positive lymph nodes, and poorer prognosis compared with AC. Surgery plus adjuvant therapy seems to be useful for SRC at the early stage, but further research is needed.

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