scholarly journals Incidence and Prognostic significance of Signet Ring Cell Histology in Gastric Cancer. A cross sectional study from Turkey: Pure Signet Ring Cell Histology in Gastric Cancer

2020 ◽  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Poor Prognosis ◽  
Prognostic Significance ◽  
Good Prognosis ◽  
Signet Ring Cell ◽  
Stage I ◽  
Stage Iii ◽  
Signet Ring ◽  
Ring Cell

Purpose: The present study aims to evaluate the incidence of signet ring cell (SRC) histology in patients with gastric cancer and its prognostic significance on the disease stage. Methods: Between November 2006 and September 2019, 309 patients were reviewed retrospectively in Kartal Koşuyolu High Specialization Training and Research Hospital Gastroenterology Surgery clinic in Turkey and the clinicopathological features and survival status were examined in the presence of ring cell histology. Results: Of the patients, 71.4% had gastric cancer with a non-SRC histology and 28.6% had an SRC histology. The presence of an SRC histology was found to be associated with young age (p=0.007), advanced depth of wall invasion (p=0.001), number of positive lymph nodes (p=0.022) and presence of vascular invasion (p=0.044). The presence of an SRC histology was associated with good prognosis in patients with stage I gastric cancer (p=0.045), but with poor prognosis in patients with stage III disease (p=0.034). The study found no significant association between stage II disease and overall survival. Conclusions: The present study found survival to be associated with good prognosis in stage I, and poor prognosis in stage III among patients with gastric cancer with SRC histology. No prognostic significance could be established for overall survival.

scholarly journals Should signet-ring cell histology alter the treatment approach for clinical stage I gastric cancer?

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 321-321
Author(s):  
Michael K. Turgeon ◽  
Adriana C. Gamboa ◽  
Manali Rupji ◽  
Rachel M. Lee ◽  
Jeffrey M. Switchenko ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Therapy ◽  
Neoadjuvant Therapy ◽  
Clinical Stage ◽  
Signet Ring Cell ◽  
Stage I ◽  
Perioperative Chemotherapy ◽  
Pathologic Stage ◽  
Signet Ring ◽  
Ring Cell

321 Background: Upfront surgery is standard of care for stage I gastric cancer. Despite this, many clinicians administer preoperative therapy for clinical stage I disease with signet ring cell histology, given its aggressive biology. We aimed to assess the validity of this practice. Methods: The National Cancer Database (2004-2015) was reviewed for pts with non-metastatic signet ring cell gastric cancer who underwent treatment with surgery alone, perioperative chemotherapy, neoadjuvant therapy, or adjuvant therapy. Analysis was stratified by preoperative clinical stage and pathologic stage. Primary outcome was overall survival (OS). Results: Of 3000 pts, median age was 61 (IQR: 51-70). 34% were clinical stage I (n = 1018) of which 53% received surgery alone (n = 542), 5% perioperative chemotherapy (n = 47), 12% neoadjuvant therapy (n = 125), and 30% adjuvant therapy (n = 304). Median follow-up was 26 mos. For clinical stage I disease, surgery alone was associated with improved median OS (108 mos) when compared to perioperative chemotherapy (80 mos), neoadjuvant therapy (41 mos), or adjuvant therapy (73 mos, all p < 0.001). For pathologic stage I, surgery alone had equivalent survival to perioperative and adjuvant therapy (5-yr OS: 81 vs 82 vs 79%, p = 0.22). Concordance between clinical and pathologic stage I was 56%, specifically, 41% of clinical stage I pts were upstaged to pathologic stage II (44%) and stage III (56%). Adjuvant therapy for these pts was associated with improved median OS compared to pretreatment (perioperative chemotherapy / neoadjuvant therapy) for those upstaged to pathologic stage II (122 vs 37mos, p < 0.001) or stage III (40 vs 18mos, p < 0.001) disease. Conclusions: Our stage-stratified study demonstrates improved survival with upfront surgery for clinical stage I signet ring cell gastric cancer. Despite 41% of clinical stage I pts being upstaged to stage II or III on final pathology, adjuvant therapy offers a favorable rescue strategy, with improved outcomes compared to those treated preoperatively. Surgery alone also affords similar survival for pathologic stage I disease compared to multimodal therapy. This study challenges the intrinsic bias to over-treat stage I signet ring cell gastric cancer.

Partial Gastrectomy is Associated with Improved Overall Survival in Signet-ring Cell Gastric Cancer

2021 ◽  
Vol 266 ◽  
pp. 27-34
Author(s):  
Maitham A. Moslim ◽  
Elizabeth Handorf ◽  
Sanjay S. Reddy ◽  
Stephanie H. Greco ◽  
Jeffrey M. Farma
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Partial Gastrectomy ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Ring Cell

scholarly journals Chemoradiotherapy Is Inferior to Chemotherapy Alone in Adjuvant Setting for Signet Ring Cell Containing Gastric Cancer

2020 ◽  
Vol 10 ◽  
Author(s):  
Yue-Ting Zhu ◽  
Xin-Zu Chen ◽  
Ye Chen ◽  
Yu-Wen Zhou ◽  
Lian-Sha Tang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Signet Ring Cell ◽  
Adjuvant Chemoradiotherapy ◽  
Signet Ring Cells ◽  
D2 Gastrectomy ◽  
Vessel Invasion ◽  
Signet Ring ◽  
Ring Cell

BackgroundSignet ring cell containing gastric cancer (SRCGC) is a rare subtype of gastric cancer, and its adjuvant therapy is based on general gastric cancer. However, the effectiveness of radiotherapy for those SRCGC patients remains unknown.PurposeThe purpose of the study was to analyze whether the addition of radiotherapy to adjuvant chemotherapy (CT) can benefit survival in resected SRCGC patients.MethodsPatients with SRCGC, who underwent D2 gastrectomy followed by adjuvant chemotherapy or chemoradiotherapy (CRT), were retrospectively collected. According to the proportion of signet ring cells, patients were histologically classified as pure SRCGC (pSRCGC) containing 100% of signet ring cells, mixed SRCGC (mSRCGC) containing &gt;50% of signet ring cells, and contaminated SRCGC (cSRCGC) containing &lt;50% of signet ring cells. Among the 272 patients, 156 were treated by CT alone and 116 by CRT. The primary endpoint was 3-year overall survival rate (3-year OS rate).ResultsWith a median follow-up of 80.5 months, the 3-year OS rate was significantly higher in the CT group (70.5% vs. 58.6%, HR = 0.633, P = 0.017) compared with CRT group. Three independent characteristics were predictive of a poor overall survival: CRT treatment (P = 0.019), tumor size ≥5 cm (P &lt; 0.001), and the presence of vessel invasion (P = 0.009). Subgroup analyses showed CRT significantly impaired prognosis in SRCGC patients in the cSRCGC subset, as well as lesions located in lower-middle sites, subtotal gastrectomy, male, &lt;60 year, and no vessel invasion. Peritoneal was the most common recurrence site in SRCGC patients. The adverse events leukopenia and neutropenia were more common in the CRT group (P = 0.007).ConclusionsAdjuvant chemoradiotherapy was associated with poor survival compared with adjuvant chemotherapy in SRCGC patients with D2 gastrectomy.

scholarly journals Signet Ring Cell Histology Is Not an Independent Predictor of Poor Prognosis After Curative Resection for Gastric Cancer

Medicine ◽  
2014 ◽  
Vol 93 (27) ◽  
pp. e136 ◽  
Author(s):  
Jung Ho Shim ◽  
Kyo Young Song ◽  
Hyung-Ho Kim ◽  
Sang-Uk Han ◽  
Min-Chan Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Poor Prognosis ◽  
Curative Resection ◽  
Independent Predictor ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Ring Cell

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.

scholarly journals Should Signet Ring Cell Histology Alter the Treatment Approach for Clinical Stage I Gastric Cancer?

2020 ◽  
Vol 28 (1) ◽  
pp. 97-105 ◽  
Author(s):  
Michael K. Turgeon ◽  
Adriana C. Gamboa ◽  
Manali Rupji ◽  
Rachel M. Lee ◽  
Jeffrey M. Switchenko ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Treatment Approach ◽  
Clinical Stage ◽  
Signet Ring Cell ◽  
Stage I ◽  
Signet Ring ◽  
Ring Cell
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