Survival predictors associated with signet ring cell carcinoma of the esophagus (SRCCE): A population-based retrospective cohort study

Abstract

PurposeSignet ring cell carcinoma of the esophagus (SRCCE) is an uncommon tumor associated with significant morbidity and mortality. There is still no consensus regarding cut-off values for tumor size, age and optimal treatment for SRCCE. Thus, we elucidated the current survival outcomes of patients with SRCCE and analyzed factors associated with prognosis.MethodsA retrospective cohort study based on the SEER (The Surveillance, Epidemiology, and End Results) program database was conducted. We identified 537 patients (461 men and 76 women) newly diagnosed with SRCCE between January 2004 and December 2014. A multivariate Cox proportional hazards model was utilized to measure the mortality-associated risk factors in patients with SRCCE after adjusting for various variables.ResultsThe 1-, 2- and 5-year disease-specific mortalities (DSM) were 51.6%, 67.6%, and 78.4%, respectively, and the median survival time was 12.0 months. The factors correlated with mortality hazard were marital status (unmarried versus married, Hazard Ratio (HR) = 1.443), tumor size (≥ 5 cm versus < 5 cm, HR = 1.444), tumor grade (high grade versus low grade, HR = 3.001), condition of primary tumor (T4 versus T1, HR = 2.178), regional lymph node metastasis (N1 versus N0, HR = 1.739), further metastasis (M1 versus M0, HR = 1.951) and chemotherapy (receiving chemotherapy versus no chemotherapy, HR = 0.464).ConclusionsThe contemporary 5-year DSM was 78.4%. Being unmarried, having a tumor size ≥ 5 cm, a high tumor grade, a score of T4 for tumor invasion of adjacent organs, a score of N1 for regional lymph node metastasis, a score of M1 for distant metastasis and no chemotherapy were independent predictors of high DSM.

Signet Ring Cell Histology Confers Worse Overall Survival in Treated Esophageal Adenocarcinoma

“…6,[8][9][10] One study using the Surveillance, Epidemiology, and End Results identified poor prognostic factors for survival but only in esophageal SRC patients. 11 It is difficult to adequately determine the pathologic and prognostic differences between esophageal SRC and nonsignet adenocarcinoma (AC), because of how rare esophageal SRC is. 12 The objective of this study was to understand the difference in clinical presentation and stage-specific treatment and survival outcomes of patients with esophageal SRC versus those with esophageal AC.…”

Nomogram for predicting the overall survival of the patients with oesophageal signet ring cell carcinoma

“…Several predictive models are currently available for oesophageal cancer (13,14,16,19,20), but none of them focus on SRC carcinoma of the oesophagus. Current studies on the prognosis of SRC of the oesophagus suggest that female sex, unmarried, invasion of adjacent organs, a high tumour grade, metastasis of regional lymph nodes or distant organs and no chemotherapy were independent prognostic factors (21,22). However, the sample sizes of these studies were small and some prognostic factors associated with oesophageal SRC were found, but no predictive models were further constructed and validated.…”

<p>Gastric Signet Ring Cell Carcinoma: Current Management and Future Challenges</p>

“…[8][9][10] These treatments are associated with limited benefits in overall survival, and median survival in the majority of clinical trials is 12 to 20 months. 9,[11][12][13] Although several prognostic and predictive factors have been investigated, including patient and tumor characteristics, none of these have provided strategies based on the unique biomarkers in GSRC. Due to inadequate predictive biomarkers, some patients were detrimentally overtreated with chemotherapy.…”

“… 8 – 10 These treatments are associated with limited benefits in overall survival, and median survival in the majority of clinical trials is 12 to 20 months. 9 , 11 - 13 …”