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

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.

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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

Case Reports in Urology ◽

10.1155/2013/915874 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 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.

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

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.529 ◽

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.

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

International Journal of Cancer ◽

10.1002/ijc.28981 ◽

2014 ◽

Vol 136 (2) ◽

pp. 333-339 ◽

Cited By ~ 46

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

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Signet Ring Cell Carcinoma of the Appendix: A Case Report of Long-Term Survival

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.72.13 ◽

2019 ◽

Vol 72 (1) ◽

pp. 13-19

Author(s):

Kenichi Ishizu ◽

Toshio Nakamura ◽

Kennnoki Kyo ◽

Kazuya Okamoto ◽

Takahiro Shimamura

Keyword(s):

Case Report ◽

Cell Carcinoma ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Term Survival ◽

Long Term Survival ◽

Signet Ring ◽

Ring Cell

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

Technology in Cancer Research & Treatment ◽

10.1177/1533033820983812 ◽

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.

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Evaluation of docetaxel- and oxaliplatin-based adjuvant chemotherapy in postgastrectomy gastric cancer patients reveals obvious survival benefits in docetaxel-treated mixed signet ring cell carcinoma patients

Medical Oncology ◽

10.1007/s12032-014-0159-5 ◽

2014 ◽

Vol 31 (9) ◽

Cited By ~ 7

Author(s):

Li Chen ◽

Yan Shi ◽

Jing Yuan ◽

Qian Wu ◽

Yalin Han ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Cell Carcinoma ◽

Cancer Patients ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Signet Ring ◽

Ring Cell ◽

Gastric Cancer Patients

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

Scientific Reports ◽

10.1038/s41598-020-70985-0 ◽

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

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NK Cells Adjuvant Therapy Reveals Obvious Survival Benefits in a Gastric Mixed Signet Ring Cell Carcinoma Patient: A Case Report

10.21203/rs.3.rs-117725/v1 ◽

2020 ◽

Author(s):

Yuan-yuan Jin ◽

Wen-zhuo Yang ◽

Zheng-yang Sun ◽

Zhong-bo Wang ◽

Jian Chen ◽

...

Keyword(s):

Cell Carcinoma ◽

Nk Cells ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

R0 Resection ◽

Therapeutic Effects ◽

Intravenous Injections ◽

Signet Ring ◽

Ring Cell ◽

One Year

Abstract Background: Advanced signet ring cell (SRC) carcinoma has a worse prognosis. Therefore, early diagnosis and prevention is particularly important; SRC tumours have lower R0 resection rate and are thought to be less chemosensitive than non-SRCC. Consequently, a novel postoperative adjuvant treatment is urgently needed to improve clinical outcomes.Case presentation: A 41-year-old female with paroxysmal vomiting for more than one year come to hospital for gastroscopy examination in 2015. The gastroscopy revealed signet ring cell carcinoma of gastric antrum and poorly differentiated adenocarcinoma in some areas. The patient was treated with radical gastrectomy for gastric cancer and oxaliplatin-based regimen for 6 cycles after surgery. Natural killer (NK) cells immunotherapy was started after November 2016, three times a year, up to now, no suspicious lesions were evident, and the levels of serum tumor markers were normal.Conclusions: Intravenous injections of NK cells combination with surgical treatment and chemotherapy showed therapeutic effects in this patient with possible relapse.

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Signet Ring Cell Carcinoma of the Ampulla of Vater With Focal Neuroendocrine Differentiation of the Amphicrine Type: Report of a Case With Long-Term Survival

International Journal of Surgical Pathology ◽

10.1177/1066896918784666 ◽

2018 ◽

Vol 27 (1) ◽

pp. 89-93 ◽

Cited By ~ 3

Author(s):

Adele Fornelli ◽

Nicola Zanini ◽

Dario De Biase ◽

Stefania Lega ◽

Raffaele Lombardi ◽

...

Keyword(s):

Cell Carcinoma ◽

Neuroendocrine Differentiation ◽

Ampulla Of Vater ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Term Survival ◽

Long Term Survival ◽

Signet Ring ◽

Ring Cell

Carcinoma of the ampulla of Vater is an uncommon neoplasm and represents 0.5% of all gastrointestinal malignancies, being less common than carcinoma of the pancreas and bile ducts. The most common ampullary tumor is the adenocarcinoma with tubular growth pattern. Signet ring cell carcinoma is extremely rare. In this article, we report a case of signet ring cell carcinoma of the ampulla of Vater showing focal neuroendocrine amphicrine differentiation and intestinal phenotype, which occurred in a 49-year-old male who is still alive 7 years after surgery, without evidence of recurrence. This long-term survival might be attributed not only to the early stage of the disease but also to the neuroendocrine differentiation and the absence of genetic alterations.

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