Outcomes of Surgical Treatment of Primary Signet Ring Cell Carcinoma of the Colon and Rectum: 22 Cases Reviewed With Literature

Bellı, Sedat; Aytaç, Hüseyin Özgür; Karagülle, Erdal; Yabanoğlu, Hakan; Kayaselçuk, Fazi̇let; Yıldırım, Sedat

doi:10.9738/intsurg-d-14-00067.1

Cited by 47 publications

(53 citation statements)

References 14 publications

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“…In agreement with previous colorectal SRCC data, 4 , 5 , 7 – 9 colorectal MAC-SRC patients were commonly diagnosed at an advanced stage in this study, with distant metastasis or lymph node metastasis. In a previous study examining 59 patients, 58 (98.3%) individuals had T3/T4 lesions, 52 (88.1%) showed lymph node metastasis, and 14 (23.7%) had distant metastasis.…”

Section: Discussionsupporting

confidence: 93%

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Characteristics and prognostic factors of colorectal mucinous adenocarcinoma with signet ring cells

Kong

Zhang

Huang

et al. 2017

CMAR

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BackgroundColorectal signet ring cell (SRC) carcinoma occurs rarely with a poor prognosis. The present study assessed the prognostic factors and predictive value of SRC ratio in colorectal mucinous adenocarcinoma (MAC) with SRCs (MAC-SRC).Patients and methodsA total of 95 consecutive colorectal MAC-SRC patients, confirmed pathologically from February 1987 to December 2015, were analyzed retrospectively in our institute. Clinical characteristics, pathological grade, TNM staging, and SRC ratio were assessed to identify the prognostic factors related to progression-free survival (PFS) and overall survival (OS). SPSS 22.0 was used for statistical analyses.ResultsThe median follow-up time was 29.7 months (range 0.8–165). Meanwhile, 5-year PFS and OS rates were 25.6% (95% confidence interval [CI] 16.192–35.008%) and 40.5% (95% CI 29.524–51.476%), respectively. Among the 81 patients who underwent surgery, 78 (96.3%) were diagnosed as stage T3 or T4; 74 (91.4%) showed lymph node involvement, and 27 (29.3%) presented distant metastasis. Metastases of the peritoneal cavity and ovaries were observed commonly in colorectal MAC-SRC. In the multivariate Cox regression model, SRC ratio ≥35%, absence of preoperative radiotherapy, and distant metastasis were independent predictors of PFS. Furthermore, SRC ratio ≥35%, absence of preoperative chemotherapy (pre-CT), and distant metastasis were independent risk factors for poor prognosis.ConclusionA long-term follow-up of colorectal MAC-SRC reveals that it is a rare subtype of colorectal MAC with a dismal prognosis. Furthermore, SRC ratio, pre-CT, and M stage seem to affect OS independently.

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Section: Discussionsupporting

confidence: 93%

“…Colorectal SRCC is associated with younger age, higher tumor grade, and poorer outcomes, compared with conventional adenocarcinoma. 4 – 9 …”

Section: Introductionmentioning

confidence: 99%

Characteristics and prognostic factors of colorectal mucinous adenocarcinoma with signet ring cells

Kong

Zhang

Huang

et al. 2017

CMAR

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“…SRCC was reported more prevalent in patients at younger age (≤ 40 y) than conventional colorectal adenocarcinoma[ 4 , 6 , 17 , 18 ]. In our study, the median age of colorectal SRCC was 46 years old, and 66% of patients were younger than 40 years old, which is obviously higher than conventional colorectal adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

The Characteristics and Prognostic Effect of E-Cadherin Expression in Colorectal Signet Ring Cell Carcinoma

Wang

et al. 2016

PLoS ONE

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PurposeSignet ring cell carcinoma (SRCC) is rare. The aim of this study is to understand the clinicopathological features and identify the possible prognostic factors in colorectal SRCC.MethodsPatients with SRCC who underwent primary lesion resection at Fudan University Shanghai Cancer Center from September 2008 to July 2014 were retrospectively analyzed. Patient’s gender, age, tumor location, depth of invasion, lymph node metastasis, synchronous distant metastasis, perineural invasion, lymphovascular invasion, and E-cadherin expression were studied with prognosis, and the correlation between E-cadherin expression and clinicopathological features were analyzed. All clinicopathological and molecular factors were put into multivariate analysis using Cox proportional hazards model for detecting independent prognostic factors.Results59 patients accounting for 0.89% of total colorectal cancer patients met the criteria and were enrolled in the study. The median survival time is 28.9 months, and the 3-year survival rate is 62.7%. SRCC were seen more common in young male patients. Advanced stage was more common in SRCC, 58 (98.3%) patients had T3/T4 lesions, 52 (88.1%) patients had lymph node metastasis, and 14 (23.7%) patients had distant metastasis. Distant metastases were seen more common in peritoneal cavity. Distant metastasis (HR = 4.194, 95% CI: 1.297–13.567), lymphovascular invasion (HR = 2.888, 95% CI: 1.115–7.483), and E-cadherin expression (HR = 0.272, 95% CI: 0.096–0.768) were independent predictors for survival.ConclusionsSRCC is a rare subtype of colorectal cancer with poor prognosis. Distant metastasis, lymphovascular invasion, and E-cadherin expression can predict prognosis of colorectal SRCCs independently. More precise therapy and more close surveillance are needed for these patients.

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“…Differently, to adenocarcinoma, the median age of presentation is under 40 years. Most series report a predominance in males, with ratios of 2:1, and is usually found in the right colon or the rectum 5…”

Section: Introductionmentioning

confidence: 99%

Signet ring cell carcinoma of the rectum: atypical metastatic presentation

et al. 2019

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Colorectal cancer is the third most common cancer in the world and the fourth most common cause of death related to cancer. Signet ring cell carcinoma represents an uncommon histological type for rectal cancer with less than 1% of all rectal neoplasms. It usually behaves aggressively and has an inferior prognosis. We present the case of a young man diagnosed with signet ring cell rectal carcinoma. He underwent neoadjuvant therapy with partial response, had surgery with curative intent and showed local recurrence after only 3 months. Disease progression happened only weeks after recurrence with metastasis to vertebrae, extraocular muscles, bone marrow and skin. He is currently receiving palliative chemotherapy.

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Outcomes of Surgical Treatment of Primary Signet Ring Cell Carcinoma of the Colon and Rectum: 22 Cases Reviewed With Literature

Cited by 47 publications

References 14 publications

Characteristics and prognostic factors of colorectal mucinous adenocarcinoma with signet ring cells

Characteristics and prognostic factors of colorectal mucinous adenocarcinoma with signet ring cells

The Characteristics and Prognostic Effect of E-Cadherin Expression in Colorectal Signet Ring Cell Carcinoma

Signet ring cell carcinoma of the rectum: atypical metastatic presentation

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