Anatomic Subsites and Prognosis of Gastric Signet Ring Cell Carcinoma: A SEER Population-based 1:1 Propensity-matched Study

Abstract Background: The dismal prognosis of gastric signet ring cell carcinoma (GSRC) is a global problem. The current study is conducted to comprehensively evaluate clinicopathological features and survival outcomes in GSRC patients stratified by anatomic subsites. Then predictive nomograms are constructed and validated to improve the effectiveness of personalized management.Method: The patients diagnosed with GSRC were recruited from the online SEER database. The influence of anatomic subsites on overall survival (OS) and cancer-specific survival (CSS) was evaluated using multivariate Cox regression and Kaplan-Meier analysis. Then we employed propensity score matching (PSM) technique to decrease selection bias and balance patients’ epidemiological factors. Predictive nomograms were constructed and validated.Results: Multivariate Cox regression demonstrated that the patients with overlapping gastric cancer (OGC) suffered the highest mortality risk for OS (HR, 1.29; 95%CI, 1.23-1.36; P<0.001) and CSS (HR, 1.33; 95%CI, 1.28-1.37; P<0.001). Age, TNM stage, tumor localization, tumor size, surgery and chemotherapy presented a highly significant relationship with OS and CSS. Following subgroup and PSM analysis, OGC patients were confirmed to have the worst OS and CSS. Then nomograms predicting 6 months, 12 months and 36 months OS and CSS were constructed. The calibration curves and reveiver operating characteristic curves demonstrated the great performance of the nomograms.Conclusion: We identified anatomic subsites as a predictor of survival in those with GSRC. Patients with OGC suffered the highest mortality risk. The proposed nomograms allowed a relatively accurate survival prediction for GSRC patients.

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Prognostic Nomograms for Nonelderly Adults with Gastric Signet Ring Cell Carcinoma

BioMed Research International ◽

10.1155/2021/1274527 ◽

2021 ◽

Vol 2021 ◽

pp. 1-15

Author(s):

Hui Wang ◽

Yao Peng ◽

Qi Huang ◽

Jingjing Wu ◽

Mingjun Zhang

Keyword(s):

Cell Carcinoma ◽

Cox Regression ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Assessment Model ◽

Survival Prediction ◽

Cox Regression Analysis ◽

Calibration Curves ◽

Signet Ring ◽

Ring Cell

Background. Nomograms were established to predict the survival for gastric signet ring cell carcinoma (GSRC) in young and middle-aged adults. Material and Methods. Eligible patients with GSRC from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and then divided into a training and a testing cohort in proportion. Independent prognostic factors were picked by univariate and multivariate Cox regression analysis to set up nomograms. The predictive effect and clinical value of nomograms were evaluated by the concordance index (C-index), calibration curves, and receiver operating characteristic curve (ROC). Results. A total of 1686 GSRC patients were subsumed into this case for analysis, including a training ( n = 1180 ) and a testing cohort ( n = 506 ). Independent risk factors related to overall survival (OS) and cancer-specific survival (CSS) comprised of race, TNM stage, tumor size, number of positive lymph nodes (PLNE), and chemotherapy. For OS, the C-indexes of the training and testing cohorts were 0.737 and 0.752, while for CSS, C-indexes were, respectively, 0.749 and 0.751. These revealed that nomograms accurately predicted OS and CSS. Calibration curves and ROC demonstrated the apparent superiority of nomograms. Conclusion. We built a well-understood and comprehensive prognostic assessment model for GSRC, which provided an individualized survival prediction in the form of a quantitative score that can be considered for clinical practice.

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Clinicopathological Characteristics and Prognosis of Signet Ring Cell Carcinoma of the Gallbladder

10.21203/rs.3.rs-154548/v1 ◽

2021 ◽

Author(s):

Jiayi Li ◽

Jun You ◽

Yanming Zhou ◽

Shijie Wang

Keyword(s):

Cell Carcinoma ◽

Cox Regression ◽

Multivariable Analysis ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Advanced Tumor Stage ◽

Dismal Prognosis ◽

Advanced Tumor ◽

Signet Ring ◽

Ring Cell

Abstract Background Signet ring cell carcinoma (SRC) is a rare histological subtype of gallbladder adenocarcinoma. The current study evaluates the clinicopathologic features and prognosis of SRC.Methods Patients with adenocarcinoma of the gallbladder were identified in the Surveillance, Epidemiology, and End Results database from 1973 to 2016. Overall survival (OS) was assessed using Cox regression method.Results Of 22,781 gallbladder adenocarcinomas retrieved, 377 (1.7%) were SRC and the other 22,404 were non-SRC. SRC was more significantly associated with older age, female gender, poor differentiation, advanced tumor stage, lymph node metastasis, distant metastasis, and advanced AJCC stage. The 1-, 2- and 5-year OS was 28.1%, 16.8% and 7.2% for SRC vs. 34.9%, 23.1% and 13.2% for non-SRC, respectively (P = 0.002). Multivariable analysis showed that the SRC histology was independently associated with a dismal prognosis (hazard ratio [HR] 1.256, P = 0.021). Surgery in combination with chemotherapy improved OS of gallbladder SRC patients compared with surgery alone (HR 0.726, P = 0.036) or chemotherapy alone (HR 0.433, P < 0.001). Conclusion Patients with SRC of the gallbladder have distinct clinicopathological features with poor prognosis. Surgery in combination with chemotherapy can improve survival.

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Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the gallbladder

BMC Gastroenterology ◽

10.1186/s12876-021-01831-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shijie Wang ◽

Jiayi Li ◽

Jun You ◽

Yanming Zhou

Keyword(s):

Propensity Score ◽

Cell Carcinoma ◽

Cox Regression ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Advanced Tumor Stage ◽

Cancer Specific Survival ◽

Advanced Tumor ◽

Signet Ring ◽

Ring Cell

Abstract Background Signet ring cell carcinoma (SRC) is a rare histological subtype of gallbladder adenocarcinoma. The current study evaluates the clinicopathologic features and prognosis of SRC. Methods Patients with adenocarcinoma of the gallbladder were identified in the Surveillance, Epidemiology, and End Results database from 1973 to 2016. Overall survival (OS) and cancer-specific survival (CSS) of patients who had SRC were compared with those of patients who had non-SRC using Cox regression and propensity score methods. Results Of 22,781 gallbladder adenocarcinomas retrieved, 377 (1.7%) were SRC and the other 22,404 were non-SRC. SRC was more significantly associated with older age, female gender, poor differentiation, advanced tumor stage, lymph node metastasis, distant metastasis, and advanced AJCC stage. The 5-year OS and CSS in the SRC group were 7.2 and 6.5%, respectively, both of which were significantly worse than the 13.2 and 13.3% seen in the SRC group (P = 0.002 and P = 0.012, respectively). This survival disadvantage persisted in multivariable analyses [hazard ratio (HR) = 1.256, P = 0.021 and HR = 1.211, P = 0.036] and after propensity score matching (OS: HR = 1.341, P = 0.012 and CSS: HR = 1.625, P = 0.005). Surgery in combination with chemotherapy improved OS of gallbladder SRC patients compared with surgery alone (HR = 0.726, P = 0.036) or chemotherapy alone (HR = 0.433, P < 0.001). Conclusion Patients with SRC of the gallbladder have distinct clinicopathological features with poor prognosis. Surgery in combination with chemotherapy can improve survival.

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

International Surgery ◽

10.9738/intsurg-d-14-00067.1 ◽

2014 ◽

Vol 99 (6) ◽

pp. 691-698 ◽

Cited By ~ 19

Author(s):

Sedat Belli ◽

Huseyin Ozgur Aytac ◽

Erdal Karagulle ◽

Hakan Yabanoglu ◽

Fazilet Kayaselcuk ◽

...

Keyword(s):

Confidence Interval ◽

Cell Carcinoma ◽

Negative Impact ◽

Lung Metastases ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Survival Times ◽

Dismal Prognosis ◽

Signet Ring ◽

Ring Cell

Abstract Colorectal primary signet ring cell carcinoma (PSRCCR) is a rare entity with a dismal prognosis, mainly because of delayed diagnosis. The objective of this study was to investigate the clinicopathologic features and prognostic factors for PSRCCR. This is a retrospective study including the data of 22 patients with PSRCCR who underwent surgery. Patients were categorized by age, sex, tumor site, and stage. Fifteen patients were male. Median age was 40 years. Sites for metastases were lymph nodes (86.4%), peritoneum (40.9%), and liver (9.1%). Most of the patients (91%) had stage III or IV tumors. The rates of curative and palliative resections performed were equal. Mean overall survival and mean progression-free survival times were found to be 33.3 ± 7.1 months (95% confidence interval, 19.4–47.2 months) and 11.8 ± 3.5 months (95% confidence interval, 4.9–18.7 months), respectively. It was concluded that site of the tumor, presence of bowel obstruction, peritoneum and lung metastases, adjacent organ infiltration, TNM stage, and efficiency of surgery have significant effects on survival. All in all, these aggressive tumors are generally diagnosed at advanced stages. Depending on the situation, survival is shorter. A high degree of vigilance is required for these patients to avoid the negative impact of late diagnosis on survival.

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Effect of signet-ring cell carcinoma histology on bladder cancer outcome.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.275 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 275-275

Author(s):

J. Wang ◽

F. Wang ◽

C. A. Enke

Keyword(s):

Urinary Bladder ◽

Cell Carcinoma ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

High Grade ◽

Cancer Specific Survival ◽

Data Set ◽

Cox Regression Analysis ◽

Signet Ring ◽

Ring Cell

275 Background: Signet-ring cell carcinoma (SRCC) of the urinary bladder is a rare entity. Recent case series of the condition showed inconsistent results. We used a population-based data set to compare the cancer specific survival of patients with signet-ring cell carcinoma vs. transitional cell carcinoma (TCC) of the urinary bladder. Methods: Signet-ring cell carcinoma of the urinary bladder and transitional carcinoma of the urinary bladder were identified in the Surveillance, Epidemiology and End Results program (2001 to 2004). Demographic and pathological characteristics at diagnosis were compared. Differences in cancer specific survival were compared with univariate and multivariate Cox regression analysis. Results: A total of 103 SRCC cases were present in the database from 2001 to 2004. In that time 14,648 cases TCC cases were diagnosed. SRCC was more common in younger than in older patients (p <0.001); more commonly presented with high grade histology (p <0.001) and advanced stage disease (p <0.001). The 3-year cancer specific survival rate was 67.0% and 33.2% for TCC and SRCC, respectively. On multivariate analysis there was an increased mortality risk in patients with SRCC vs TCC (HR 1.42, 95% CI 1.03–1.97, p <0.001). When only high grade cases of SRCC and TCC were compared, the risk was still worse in SRCC (HR 1.430, 95% CI 1.035–1.976, 0.03). When only local stage of SRCC and TCC were compared, the risk was worse in SRCC (HR 4.294, 95% CI 1.035–17.825, 0.045). Limited to patient who underwent cystectomy only, the difference in cancer specific survival disappeared (HR 1.289, 95% CI 0.771–2.155, 0.33). Conclusions: Even after adjusting for demographic, pathological and treatment factors, cancer specific survival is significantly worse in patients with SRCC than TCC. Further research into the biology of this rare tumor is required to explain these results. No significant financial relationships to disclose.

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Superior survival in right-sided versus left-sided colon signet ring cell carcinoma

Scientific Reports ◽

10.1038/s41598-020-74926-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Zhuang Zhao ◽

Dun-wei Wang ◽

Na Yan ◽

Shu Pan ◽

Zhi-wen Li

Keyword(s):

Cell Carcinoma ◽

Regional Lymph Node ◽

Prognostic Indicator ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Cancer Specific Survival ◽

Regional Lymph Node Dissection ◽

Signet Ring ◽

Ring Cell ◽

The Right

Abstract This study aimed to explore the association of tumor sidedness with the prognosis of patients with colon signet ring cell carcinoma (SRCC). Eligible patients were retrieved from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. Cancer-specific survival (CSS) and overall survival (OS) were compared between patients with left-sided colon SRCC and those with right-sided lesions. A total of 2660 patients were included, among them, 1983 (74.5%) had right-sided colon SRCC. Compared to patients with left-sided colon SRCC, those who had the right-sided colon SRCC showed higher proportion of white race, female, aged ≥ 65 years, receiving total colectomy and ≥ 4 regional lymph node dissection; while had lower proportion of advanced AJCC stage. Besides, right-sided patients exhibited superior 5-year CSS (32.74% vs. 25.89%, P = 0.001) and OS (27.38% vs. 23.02%, P = 0.024) rates compared with left-sided ones. Multivariate analysis revealed that tumor sidedness was an independent prognostic factor. To be specific, patients with right-sided colon SRCC showed better CSS (HR: 0.873; 95% CI 0.777–0.981; P = 0.023) and OS (HR: 0.838; 95% CI 0.753–0.965; P = 0.002). Moreover, subgroup analysis demonstrated superior CSS and OS for right-sided patients in most subgroups. Tumor sidedness was an independent prognostic indicator for colon SRCC. Besides, patients with right-sided colon SRCC have superior prognosis than those with left-sided lesions.

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Preoperative Radiotherapy Is Associated With Significant Survival Benefits for Patients With Gastric Signet Ring Cell Carcinoma: A SEER-Based Approach

Technology in Cancer Research & Treatment ◽

10.1177/1533033820960746 ◽

2020 ◽

Vol 19 ◽

pp. 153303382096074

Author(s):

Hongyun Gong ◽

Yuxin Chu ◽

Qinyong Hu ◽

Qibin Song

Keyword(s):

Cell Carcinoma ◽

Preoperative Radiotherapy ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Proportional Hazard ◽

Cancer Specific Survival ◽

Cox Proportional Hazard ◽

Significant Survival ◽

Signet Ring ◽

Ring Cell

Objective: To explore the clinical and pathological features of gastric signet ring cell carcinoma, and evaluate the survival impact of preoperative radiotherapy on these patients. Methods: The Surveillance, Epidemiology, and End Results database was used to extract eligible patients from 2004 to 2015. The patients were divided into those with and without preoperative radiotherapy. The categorical variables were described by chi-square tests. The patients’ survival was compared between the 2 groups by Kaplan-Meier method with log-rank tests. Cox proportional hazard model was adopted to identify prognostic factors of cancer-specific survival. Results: Totally 4771 patients were recruited, of whom 218(4.6%) patients received preoperative radiotherapy, while 4553(95.4%) patients didn’t receive this treatment. Survival analysis of the entire cohort demonstrated that preoperative radiotherapy improved both cancer-specific survival and overall survival (p < 0.001) of the patients. Cox proportional hazard models identified age >60, tumor size >50 mm, TNM stage II-IV as independent risk factors for poor prognosis (HR > 1, p < 0.05). Notably, preoperative radiotherapy was identified as an independent protective factor for favorable prognosis (HR < 1, p < 0.05). Subgroup survival analysis showed that preoperative radiotherapy exerted significant survival benefits for the stages III and IV patients. Conclusions: In this population-based study, preoperative radiotherapy is associated with significant survival benefits for the patients with advanced gastric signet ring cell carcinoma. Hence preoperative radiotherapy is feasible for these patients.

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Marital status and survival of patients with colorectal signet ring cell carcinoma: a population-based study

Scientific Reports ◽

10.1038/s41598-020-74720-7 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Li Feng ◽

Yong-jing Yang ◽

Juan Du ◽

Yong-jiang Yu ◽

Jian-dong Diao

Keyword(s):

Marital Status ◽

Cell Carcinoma ◽

Prognostic Indicator ◽

Population Based ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Cancer Specific Survival ◽

Large Tumor ◽

Signet Ring ◽

Ring Cell

Abstract The prognostic role of marital status on colorectal signet ring cell carcinoma (SRCC) has not been studied. In this study, the correlation of marital status with prognosis of colorectal SRCC was analyzed. Eligible subjects were extracted from the Surveillance, Epidemiology, and End Results (SEER) dataset from 2004 to 2015, followed by comparison of cancer-specific survival (CSS) and overall survival (OS) between married and unmarried group. 3152 patients were identified including 1777 married patients (56.38%). Married populations tended to be more patients aged < 65, male, receiving chemotherapy, and less black race and large tumor size compared to unmarried group (all P < 0.05).Moreover, 5-year CSS (30.04% vs. 28.19%, P = 0.0013) and OS rates (26.68% vs. 22.94%, P < 0.0001) were superior in married population. Multivariate analysis revealed that marital status was an independent favorable prognostic indicator, and married population had better CSS (HR: 0.898; 95% CI: 0.822–0.980; P = 0.016) and OS (HR: 0.898; 95%CI: 0.827–0.975; P = 0.011).In addition, CSS as well as OS were superior in married populations than unmarried ones in most subgroups. Marital status was an independent prognostic factor for survival in patients with colorectal SRCC. Additionally, married patients obtained better survival advantages.

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Radiotherapy Improves the Prognosis in Signet Ring Cell Carcinoma and Non-Signet Ring Cell Gastric Adenocarcinoma Patients: A SEER Database Analysis

Austin Journal of Pulmonary and Respiratory Medicine ◽

10.26420/austinjpulmrespirmed.2021.1075 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Wang C ◽

◽

Li H ◽

Luo J ◽

Liu R ◽

...

Keyword(s):

Cell Carcinoma ◽

Survival Rates ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Seer Database ◽

Cancer Specific Survival ◽

Pathological Characteristics ◽

Signet Ring Cell Adenocarcinoma ◽

Signet Ring ◽

Ring Cell

Objective: To investigate the effect of radiotherapy on prognosis in gastric signet ring cell carcinoma (SRCC) and gastric non-signet ring cell adenocarcinoma (NSRCC) patients. Methods: A total of 23,971 patients diagnosed with gastric cancer were collected from 2004 to 2013 by SEER database, including 17,679 NSRCC patients and 6,292 SRCC patients. Patients were divided to two groups and compared according to whether radical gastrectomy was performed on them. After clinic pathological characteristics of the two groups were balanced by the propensity score matching (PSM) method, survival rates of the two groups were then compared. Results: The Over Survival (OS) and Cancer-Specific Survival (CSS) time of SRCC and NSRCC patients in the radiotherapy groupwere significantly better than those in the non-radiotherapy group. But the clinical and pathological characteristics (gender, age, pathological differentiation degree, T stage, N stage, and metastasis) of the two groups were significantly unbalanced (p<0.001). After 1:1 PSM matching, it was found that radiotherapy had no significant effect on OS and CSS time of NSRCC patients, but radiotherapy could significantly improve OS and CSS time of SRCC patients. Conclusion: SRCC patients are more sensitive to radiotherapy than NSRCC patients. Although the prognosis of SRCC is far less than that of NSRCC patients, the treatment strategy of surgical resection of primary lesions combined with radiotherapy should be recommend for SRCC patients, and whether radiotherapy benefits NSRCC patients still needs to be further studied.

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