scholarly journals The value of adjuvant chemotherapy in stage II/III colorectal signet ring cell carcinoma

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhuang Zhao ◽  
Na Yan ◽  
Shu Pan ◽  
Dun-wei Wang ◽  
Zhi-wen Li
Keyword(s):  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Stage Ii ◽  
Signet Ring ◽  
Ring Cell

Colorectal signet-ring cell carcinoma: Responsive to adjuvant chemotherapy but still a poor prognosis.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 529-529
Author(s):  
Niek Hugen ◽  
Rob H. A. Verhoeven ◽  
Valery E. P. P. Lemmens ◽  
Carola J. C. Van Aart ◽  
Marloes A. G. Elferink ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Treatment Guidelines ◽  
Relative Survival ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Prognostic Impact ◽  
Colon And Rectal Cancer ◽  
Signet Ring ◽  
Ring Cell

529 Background: Colorectal signet-ring cell carcinoma (SRCC) has been associated with a poor survival compared to mucinous adenocarcinoma (MC) and the common adenocarcinoma (AC). Prognostic impact of tumor localization is unknown and efficacy of adjuvant chemotherapy in SRCC has never been assessed. This study analyses prognostic impact of SRCC and determines whether SRCC patients benefit from adjuvant chemotherapy for colon cancer equally compared with AC. Methods: Data on 196,757 patients with CRC in the Netherlands in the period 1989 and 2010 was included in this nationwide population-based study. Five-year relative survival estimates were calculated and multivariate relative survival analyses using a multiple regression model of relative excess risk (RER) were performed. Results: SRCC was found in 1.0% of CRC patients. SRCC patients presented more frequently with stage III or IV disease than AC (75.2% versus 43.6%, P<0.0001) and SRCC was more frequently found in the proximal colon (57.7% versus 32.0%, P<0.0001). SRCC patients had a poor 5-year relative survival of 31% in colon and 20% in the rectum compared to 57% and 59% in AC (P<0.0001). This poorer survival for SRCC was found in stage II, III and IV. In comparison with AC, there was no significant interaction between SRCC and adjuvant chemotherapy (RER 1.10, 95% CI 0.81-1.51), suggesting a comparable benefit from adjuvant chemotherapy in AC and SRCC. Conclusions: Prognostic impact of SRCC is dismal in both colon and rectal cancer patients, but colonic SRCC patients seem to benefit from adjuvant chemotherapy equally compared with AC. Reduced efficacy of adjuvant chemotherapy therefore does not seem to explain the poor outcome in SRCC patients. We recommend to adhere to adjuvant treatment guidelines for all histological subtypes, but encourage clinical trials to take histological subtype into account for stratification.

scholarly journals Colorectal signet-ring cell carcinoma: benefit from adjuvant chemotherapy but a poor prognostic factor

2014 ◽  
Vol 136 (2) ◽  
pp. 333-339 ◽  
Author(s):  
Niek Hugen ◽  
Rob H. Verhoeven ◽  
Valery E Lemmens ◽  
Carola J. van Aart ◽  
Marloes A. Elferink ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Prognostic Factor ◽  
Cell Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Poor Prognostic Factor ◽  
Signet Ring ◽  
Ring Cell

The effects of combined modality therapy on stage II-III primary gastric signet ring cell carcinoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16530-e16530
Author(s):  
Yang Li ◽  
Yantao Tian ◽  
Zhikai Zhu
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Combined Modality Therapy ◽  
Tumor Location ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Stage Ii ◽  
Ajcc Stage ◽  
Signet Ring ◽  
Ring Cell

e16530 Background: To date, there is no well-defined standard of care for gastric signet ring cell carcinoma (GSRC). Clinical guidelines support that combined modality therapy (CMT) on localized gastric cancer, but this may not be appropriate for GSRC as it was generally found to be chemo-resistant. We conducted a population-based study to examine the effects of therapeutic strategies on survival outcomes by using the Surveillance, Epidemiology, and End Results (SEER) data. Methods: Analyses included primary GSRC patients with stage II-III who survived more than 6 months, and were diagnosed between 2006 and 2016 from SEER data.CMT were categorized as gastrectomy group, adjuvant CT group (gastrectomy with adjuvant chemotherapy), neoadjuvant RT group (gastrectomy with neoadjuvant radiotherapy combined adjuvant chemotherapy), and adjuvant CRT group (gastrectomy with chemoradiotherapy). Survival analyses were conducted by Kaplan-Meier method and multivariate Cox proportional hazards models, adjusted for age, gender, race, marital status, histology, AJCC stage, tumor location, and lymph nodes removed. Models were stratified by gender, AJCC stage, lymph nodes removed and tumor location. Results: Of the 1,717 cases of stage II-III primary GSRC, the mean age was 66.9 (SD: 11.0) years, over a half were male (52.8%), and the majority were white (66.0%). A total of 39.9% received adjuvant CRT. The five-year overall survival (OS) rate was 34.6% for this treatment, and 29.6% for adjuvant CT group, 25.4% for adjuvant CRT group, only 23.8% for the gastrectomy group. The median OS of patients treated with adjuvant CRT was significantly longer than that of the gastrectomy group (33 vs 24 months, aHR = 0.71, 95%CI = 0.60,0.84). Although the crude model showed a significant association between adjuvant CT and total survival (cHR = 0.81, 95%CI = 0.68,0.96), the effect measure turned null in the multivariable and sub-group analysis. Independent prognostic factors were adjuvant CRT, ≥60 years old, AJCC stage, and > 20 lymoh nodes removed. Conclusions: In this study, GSRC patients with stage II-III experienced improved overall survival after receiving adjuvant CRT, which provides several treatment implications. Future clinical trials considering adjuvant CRT will be needed to verify the conclusion derived from this study.

Prognostic value of tumor-infiltrating lymphocytes in signet-ring cell carcinoma of the rectum and sigmoid colon.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15079-e15079
Author(s):  
Jiaolin Zhou ◽  
Jia Wang ◽  
Yaping Xu ◽  
Guole Lin ◽  
Huanwen Wu ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Sigmoid Colon ◽  
Tumor Infiltrating Lymphocytes ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Stage Ii ◽  
Survival Outcomes ◽  
Signet Ring ◽  
Ring Cell ◽  
Infiltrating Lymphocytes

e15079 Background: Signet-ring cell carcinoma (SRCC) of rectum and sigmoid colon is an extremely rare subtype of colorectal cancer (CRC) with very poor prognosis. Tumor-infiltrating lymphocytes (TILs) signify the host immune response to tumors, which were reported to predict survival outcomes of patients with various cancer types. In this study, we aimed to characterize TILs and mutational features of SRCC of rectum and sigmoid colon as well as their correlations with the clinicopathological parameters and survival outcomes. Methods: 28 patients with stage II-IV SRCC of rectum and sigmoid colon were included, in which 12 patients had tumors with ≥50% signet-ring cells (SRCs) and 16 had tumors with <50% SRCs. Targeted next generation sequencing using a 1,021-gene panel was used to investigate the genetic alterations of tumor tissue. Multiplex immunofluorescence assays were performed to visualize TILs. TILs within cancer cell nests (iTILs) and in cancer stroma (sTILs) were counted separately. The correlations of TILs with survival outcomes were analyzed in stage II/III patients who underwent the radical resection. Results: Somatic alterations were detected in all the 28 cases. The most frequently mutated genes included TP53, APC and SMAD4, occurring in 68%, 36% and 36% of cases, respectively. BRAF mutation were detected in only one patient (3.6%). The median tumor mutational burden (TMB) was 4.80 (range, 0.96-42.24) muts/Mb. Three patients (10.7%) were with microsatellite instability-high (MSI-H) status and a high TMB of more than 10 muts/Mb. Patients with stage IV tumors have significantly lower PD-1+ CD8+ iTILs and sTILs (p=0.018 for both), CD8+ iTILs (p=0.022), and PD-1+ iTILs (p=0.013) levels than those with stage II/III tumors. Tumors with ≥ 50% SRCs showed lower levels of CD8+ sTILs than those with < 50% SRCs (p=0.046). Patients with CEA>5.0 ng/ml showed significantly lower levels of PD-1+ CD8+ iTILs than those with CEA≤5.0 ng/ml (p=0.015). Moreover, significantly lower levels of PD-1+ CD8+ sTILs (p=0.036) were observed in tumors that appeared as long circumferential thickening of the bowel wall with stenosis compared to those did not. Multivariate analysis indicated that patients with high PD-1+ CD8+ iTILs and sTILs levels had significantly better disease-free survival (DFS) than those with low PD-1+ CD8+ iTILs and sTILs levels (not reached vs. 22 months for both; p=0.008 and 0.003, respectively). High PD-1+ CD3+ sTILs levels were associated with significantly longer overall survival (OS) compared to low levels (not reached vs. 39 months, p=0.034). No correlation between MSI or TMB and DFS or OS was observed in this small cohort. Conclusions: Our results demonstrated that PD-1+ CD8+ iTILs and sTILs are powerful independent predictors of survival outcomes in patients with resectable SRCC of rectum and sigmoid colon. Further investigations in larger cohorts are needed to validate our findings.

scholarly journals Clinical Characteristics and Prognostic Analysis of Patients With Signet Ring Cell Gastric Carcinoma

2020 ◽  
Vol 19 ◽  
pp. 153303382098381
Author(s):  
Jia Mi Yu ◽  
Zhou Wei Zhan ◽  
Jing Xian Zhen ◽  
Xiao Jie Wang ◽  
Yu Chen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Gastroesophageal Junction ◽  
Tumor Stage ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Ring Cell

We do not know the clinical and prognostic factors that influence the survival of patients with gastric signet ring cell carcinoma (SRC). Therefore, a retrospective review was undertaken of 219 patients with SRC who had undergone gastrectomy between January 2009 and December 2012 in our hospital. Patient age, sex, TNM stage, vessel carcinoma embolus, perineural invasion, tumor site and operation type, postoperative chemotherapy, and five-year overall survival were recorded and evaluated. In our study, 93 cases (42.5%) were signet ring cell carcinoma only, and 126 cases (57.5%) were signet ring cell carcinoma coexisting with other components (such as adenocarcinoma or mucus adenocarcinoma). Eighty-three patients were female, 136 were male, 46 occurred at the gastroesophageal junction (21.0%), 63 at the fundus/body (28.8%), 80 were antrum/pylorus (36.5%), and 30 were whole stomach (13.7%). The prognosis of gastric antrum/ pylorus cancer was the best (P < 0.05). There were 133 patients (60.7%) with stage III, and the single factor analysis showed that the earlier the stage, the better the prognosis. The overall five-year survival rate was 30.1% in all patients. One-hundred and 41 patients (64.4%) received D2 radical surgery, 64 (29.2%) received D1 radical operation, and 14 (6.4%) received palliative resection, and the patients who received D2 had the best overall survival (P < 0.05). The survival time of the paclitaxel-based regimen in postoperative adjuvant chemotherapy tended to be prolonged. There was no statistical difference in overall survival between the percentage of signet-ring cells and sex. In summary, age, tumor stage, and surgical resection combined with D2 lymphadenectomy were independent prognostic factors for SRC. Adjuvant chemotherapy with a paclitaxel-based regimen may improve the survival of patients with SRC.

scholarly journals Improving survival of stage II‐III primary gastric signet ring cell carcinoma by adjuvant chemoradiotherapy

2020 ◽  
Vol 9 (18) ◽  
pp. 6617-6628
Author(s):  
Yang Li ◽  
Zhikai Zhu ◽  
Fuhai Ma ◽  
Liyan Xue ◽  
Yantao Tian
Keyword(s):  
Cell Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Stage Ii ◽  
Adjuvant Chemoradiotherapy ◽  
Signet Ring ◽  
Ring Cell

scholarly journals Long-Term Survival of a Patient with Invasive Signet-Ring Cell Carcinoma of the Urinary Bladder Managed by Combined S-1 and Cisplatin Adjuvant Chemotherapy

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Takashi Hamakawa ◽  
Yoshiyuki Kojima ◽  
Taku Naiki ◽  
Yasue Kubota ◽  
Takahiro Yasui ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Urinary Bladder ◽  
Cell Carcinoma ◽  
Radical Cystectomy ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Term Survival ◽  
Signet Ring ◽  
Ring Cell

Primary signet-ring cell carcinoma of the urinary bladder is extremely rare and patient survival is very poor. The disease usually presents at advanced stages because the cancer progresses rapidly. The only option for effective treatment is radical cystectomy, and no effective chemotherapy has been established for this variant. We report a case of signet-ring cell carcinoma of the urinary bladder with a long-term survival of 90 months owing to radical cystectomy and combination adjuvant chemotherapy with S-1 and cisplatin. To our knowledge, this is the first report to demonstrate the long-term therapeutic activity of combination S-1 and cisplatin adjuvant chemotherapy against invasive signet-ring cell carcinoma of the urinary bladder.

scholarly journals Long-Term Survival by Resection and Adjuvant Chemotherapy With S-1 in Pancreatic Signet Ring Cell Carcinoma: a Case Report With Literature Review

2020 ◽  
Author(s):  
Akihiko Takagi ◽  
Satoshi Tokuda ◽  
Takeo Toda ◽  
Kazuya Higashizono ◽  
Keisei Taku ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Portal Vein ◽  
Cell Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Good Prognosis ◽  
Signet Ring Cell ◽  
Term Survival ◽  
Signet Ring ◽  
Ring Cell ◽  
One Year

Abstract Background: Signet ring cell carcinoma (SRCC) of the pancreas is a very rare histologic variant of pancreatic carcinoma with very poor prognosis. We present a case of pancreatic SRCC with good prognosis achieved by resection and adjuvant chemotherapy with S-1 one year, which is the standard treatment for advanced resected gastric cancer in Japan. The stomach carried a higher incidence of SRCC than other sites.Case presentation: A 70-year-old man presented with abdominal discomfort, and ultrasonography revealed a mass in the pancreas. Computed tomography showed a hypovascular tumor in the head of the pancreas, 51 mm in diameter, with invasion to the portal vein and duodenum. The patient underwent pancreaticoduodenectomy (PD) with portal vein resection and reconstruction. The pathological diagnosis was SRCC of the pancreas without invasion to the portal vein, pT3N1M0 Stage IIB (UICC classification). Subsequently, postoperative adjuvant chemotherapy with S-1 was initiated to prevent recurrence. The patient has remained recurrence-free for 2 years and 6 months after PD. Conclusion: Adjuvant chemotherapy with S-1 may be an important factor for improving the prognosis of patients with resectable SRCC of the pancreas.

scholarly journals Clinical Significance of coexisting histological diffuse type in stage II/III gastric cancer: A retrospective study

2020 ◽  
Author(s):  
Hiroaki Tanaka ◽  
Mami Yoshii ◽  
Yuichiro Miki ◽  
Tatsuro Tamura ◽  
Takahiro Toyokawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Stage Ii ◽  
Intestinal Type ◽  
Stage Iii ◽  
Diffuse Type ◽  
Signet Ring ◽  
Ring Cell

Abstract Background: Since 1965, the Laurén classification has been used most commonly for gastric adenocarcinoma, with two types, intestinal type and diffuse type. Signet ring cell carcinoma (Sig) and non-solid poorly differentiated adenocarcinoma (Por2) are the histological forms of diffuse type and are often found in advanced tumors, and they seem to be associated with a poor prognosis. S-1 based adjuvant chemotherapy for patients with stage II/III gastric cancer has generally been accepted in Japan, but histological type does not alter treatment strategy. The aim of the present study was to investigate the prognostic impact of the histopathologic mixture of Sig and Por2 in patients with stage II/III gastric cancer treated with S-1 adjuvant chemotherapy.Methods: The clinicopathological data of 968 gastric carcinoma patients who underwent gastrectomy between 2007 and 2016 at our department were retrospectively analyzed. In this study, tumors containing Sig or Por2 were classified as Diffuse type, and those not containing them were classified as Intestinal type.Results: There were 307 cases of Diffuse type and 661 of Intestinal type. Diffuse type included 189 cases with Sig. Pathological diagnosis of Sig was an independent risk factor for peritoneal recurrence in patients with stage II/III. Patients with Diffuse type had worse overall survival than those with Intestinal type in Stage III. Of the patients who received S-1 adjuvant chemotherapy, the prognosis of Stage III patients with Sig but not Por2 was Significantly worse compared to patients with Intestinal type.Conclusions: The coexistence of Signet ring cell carcinoma in the primary tumor was associated with a poor prognosis in patients with stage III gastric cancer. These findings suggest that, because mixed Sig gastric cancer had a high risk of peritoneal recurrence even if adjuvant chemotherapy were performed, the pathological diagnosis should be considered when determining the therapeutic strategy for adjuvant chemotherapy in stage III gastric cancer.

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