scholarly journals Prognostic Analysis of Gastric Signet Ring Cell Carcinoma and Hepatoid Adenocarcinoma of the Stomach: A Propensity Score-Matched Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Yu Yang ◽  
Yuxuan Li ◽  
Xiaohui Du
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Cox Regression ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Standardized Mortality Ratio ◽  
Prognostic Analysis ◽  
Significant Difference ◽  
Signet Ring ◽  
Mortality Ratio

BackgroundHepatoid adenocarcinoma of the stomach (HAS) is a rare type of primary gastric cancer, and most previous studies have reported that HAS has a poor prognosis due to its aggressive biological behavior. The aim of this study was to compare the prognosis of HAS to that of gastric signet ring cell carcinoma (SRC).MethodsThis was a single-center, retrospective, observational cohort study (January 2010 to January 2016) of gastric cancer patients with pathological HAS and SRC. Overall survival was compared between HAS and SRC patients. We used univariate Cox regression, multivariate Cox regression, propensity score matching (PSM), inverse probability of treatment weighting, standardized mortality ratio weighting, standardized mortality ratio weighting, and overlap weighting to perform a prognostic analysis.ResultsA total of 725 (672 SRC and 53 HAS) patients were included. After nearest-neighbor 1:4 PSM, 200 SRC patients and 50 HAS patients were matched. Only in univariate Cox regression analysis with the cohort before PSM did HAS show a significantly worse prognosis than SRC [hazard ratio (HR), 1.66; 95% confidence interval (CI), 1.02–2.69, p = 0.040]. However, in the analysis of multivariate Cox regression with the cohort before PSM and series analysis based on the propensity score, all of the results indicated that there was no statistically significant difference in overall survival between HAS and SRC (all p > 0.05). Furthermore, in the subgroup of proximal location (p = 0.027), T stage 4a & 4b (p = 0.001), N stage 3a & 3b (p = 0.022), with cancer nodules (p = 0.026), serum CEA higher than the normal value (p = 0.038), and serum CA199 higher than the normal value (p = 0.023), the prognosis of HAS was significantly worse than that of SRC.ConclusionBased on our study, there was no statistically significant difference in overall survival between HAS and gastric SRC patients. However, in patients with an advanced tumor stage, HAS may have a worse overall survival than SRC.

scholarly journals The prognostic significance of different proportion of signet-ring cells of colorectal carcinoma

2021 ◽  
Author(s):  
Wei Chen ◽  
Huajun Cai ◽  
Kui Chen ◽  
Xing Liu ◽  
Weizhong Jiang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Staging System ◽  
Signet Ring Cell ◽  
Significant Difference ◽  
Signet Ring ◽  
Ajcc Staging System ◽  
Ajcc Staging

While the prognosis of patients with partial SRCC (PSRCC) has been rarely reported, colorectal signet-ring cell carcinoma (SRCC) has been associated with poor prognosis. The aim of this study was to analyze the prognosis of patients with different SRC composition and establish a prediction model. A total of 91 patients with SRC component were included in the study. These patients were divided into two groups: SRCC group (SRC composition > 50%; n=41) and partial SRCC (PSRCC) group (SRC composition ≤ 50%; n=50). COX regression model was used to identify independent prognostic factors for overall survival (OS). A predictive nomogram was established and compared with the 7th AJCC staging system. After a median follow-up of 16 months, no significant difference in OS was observed in either group. Preoperative carcinoembryonic antigen (CEA) level, pN stage, M stage, preoperative ileus, and adjuvant chemotherapy were independent prognostic risk factors for OS (p<0.05). A nomogram for predicting the overall survival of colorectal SRCC was established with a C-index of 0.800, and it showed better performance than that of the 7th AJCC staging system (p<0.001). In summary, the ratio of SRC component was not an independent prognostic factor of the OS. Those patients with less than 50% of SRC component should be given the same clinical attention. A predictive nomogram for survival based on five independent prognostic factors was developed and showed better performance than the 7th AJCC staging system. This resulted to be helpful for individualized prognosis prediction and risk assessment.

scholarly journals Gastric signet ring cell carcinoma

2020 ◽  
Vol 2 (4) ◽  
pp. Press
Author(s):  
Vitorino Modesto Santos ◽  
Laura Campos Modesto
Keyword(s):  
Overall Survival ◽  
Progression Free Survival ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Advanced Stage ◽  
Elderly Male ◽  
Free Survival ◽  
Significant Difference ◽  
Signet Ring ◽  
Ring Cell

Zemni I et al. reviewed clinic and pathological characteristics and outcomes of gastric signet ring cell carcinomas (J Gastric Surg 2020; 2(3):71-78) focusing on the major prognostic factors of progression-free survival and overall survival including hypoproteinemia, tumor size, stenosis, advanced stage, and recurrence. The majority of patients were males under 60 years of age. The data were compared with those of non-signet ring cell gastric carcinomas. There was no significant difference in the 5 years overall survival between the compared groups. The increasing incidence of aggressive tumors in an advanced stage with poor outcome is emphasized and additional comments are about gastric signet ring cell tumors that affected a female and an elderly male.

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

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.

scholarly journals A Prognostic Model for Patients With Gastric Signet Ring Cell Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110279
Author(s):  
Qinping Guo ◽  
Yinquan Wang ◽  
Jie An ◽  
Siben Wang ◽  
Xiushan Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Training Set ◽  
Cox Regression Analysis ◽  
Signet Ring ◽  
Ring Cell ◽  
Independent Risk Factors

Background: The aim of our study was to develop a nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRC). Methods: GSRC patients from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and validation sets. Multivariate Cox regression analyses screened for OS and CSS independent risk factors and nomograms were constructed. Results: A total of 7,149 eligible GSRC patients were identified, including 4,766 in the training set and 2,383 in the validation set. Multivariate Cox regression analysis showed that gender, marital status, race, AJCC stage, TNM stage, surgery and chemotherapy were independent risk factors for both OS and CSS. Based on the results of the multivariate Cox regression analysis, prognostic nomograms were constructed for OS and CSS. In the training set, the C-index was 0.754 (95% CI = 0.746-0.762) for the OS nomogram and 0.762 (95% CI: 0.753-0.771) for the CSS nomogram. In the internal validation, the C-index for the OS nomogram was 0.758 (95% CI: 0.746-0.770), while the C-index for the CSS nomogram was 0.762 (95% CI: 0.749-0.775). Compared with TNM stage and SEER stage, the nomogram had better predictive ability. In addition, the calibration curves also showed good consistency between the predicted and actual 3-year and 5-year OS and CSS. Conclusion: The nomogram can effectively predict OS and CSS in patients with GSRC, which may help clinicians to personalize prognostic assessments and clinical decisions.

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

2021 ◽  
Author(s):  
Yangyang Xie ◽  
Xue Song ◽  
Haimin Jin ◽  
Zhongkai Ni ◽  
Xiaowen Li ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Mortality Risk ◽  
Cox Regression ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Survival Prediction ◽  
Cancer Specific Survival ◽  
Dismal Prognosis ◽  
Signet Ring ◽  
Ring Cell

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.

scholarly journals Clinical Efficacy of Radiotherapy Combined with Surgery for Locally Advanced Gastric Signet-Ring-Cell Carcinoma: A SEER Database Analysis

2021 ◽  
Author(s):  
Xiaohan Lin ◽  
Biyu Chen ◽  
Wei Zheng ◽  
Shugang Yang ◽  
Guangwei Zhu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cell Carcinoma ◽  
Clinical Efficacy ◽  
Postoperative Radiotherapy ◽  
Locally Advanced ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Seer Database ◽  
Signet Ring ◽  
Ring Cell

Abstract Background: The objective of this study was to assess the clinical efficacy of radiotherapy combined with surgery for locally advanced gastric signet-ring-cell carcinoma (GSRCC). Methods: Clinical data of patients with locally advanced GSRCC diagnosed by postoperative pathology from 2000-2016 were collected from the US Surveillance, Epidemiology and End Results (SEER) database. All the enrolled patients were divided into three groups according to treatment type: surgery alone (S; N=727), surgery with preoperative radiotherapy (RT+S; N=138), surgery with postoperative radiotherapy (S+RT; N=548). Results: The median overall survival (OS) time in S, RT+S and S+RT group was 19, 26 and 33 months, respectively; the overall survival (OS) rate was 19.5%, 26.9% and 34.0%, respectively; the median cancer-specific survival (CSS) time was 29, 31 and 43 months, respectively; and the CSS rate was 32,4%, 35.3% and 43.6%, respectively. After performing propensity score matching (PSM), it was found that the OS rate was significantly lower in S group than in RT+S or S+RT group (all P<0.05) and the CSS rate was lower in the SA group than in the S+RT group (P<0.0001) while there was no significant difference between S and RT+S groups. The OS and CSS were not significantly different between RT+S and S+RT groups. Cox multivariate analysis showed that radiotherapy was an independent prognostic factor for OS and CSS of locally advanced GSRCC.Conclusions: Compared to surgery alone, surgery combined with preoperative or postoperative radiotherapy is beneficial to the long-term survival of patients with locally advanced GSRCC.

scholarly journals Using nomograms to predict prognostic factors in young colorectal mucinous and signet-ring cell adenocarcinoma patients

2019 ◽  
Vol 39 (7) ◽  
Author(s):  
Baochun Wang ◽  
Juntao Zeng ◽  
Yuren Liu
Keyword(s):  
Patient Population ◽  
Cox Regression ◽  
Young Patients ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Signet Ring Cell Adenocarcinoma ◽  
Kaplan Meier ◽  
Signet Ring ◽  
Ring Cell

Abstract Due to insufficient quantitative evaluation of the clinic-pathological features and prognosis of young colorectal cancer (CRC) with mucinous adenocarcinoma (MAC) and signet-ring cell carcinoma (SRC), the aim of our study was to develop a nomogram to identify the prognostic predictors for overall survival (OS) in this patient population. We retrospectively evaluated the patient records of MAC and SRC patients aged ≤ 40 years. Kaplan–Meier analysis and log-rank testing were performed to estimate OS. A nomogram predicting OS was created for risk quantitation and decision tree analysis was performed for patient grouping. With a median follow-up of 36.5 months, we included a total of 90 young CRC patients for analysis. The overall cumulate 5-year OS rate was 57.7% (95% confidence interval (CI): 45.1–68.5%). The estimated 5-year OS was 62.9% (95% CI: 48.5–74.3%) for MAC and 37.3% (95% CI: 14.4–61.2%) for SRC (P=0.021). The recurrence rate was significantly greater in the SRC group compared with the mucinous group (52.4 compared with 26.1%, P=0.047). In the multivariate Cox regression model, preoperative carcinoembryonic antigen (CEA) levels and cycles of adjuvant chemotherapy (CT) were found to be an independent prognostic factor for OS (hazard ratio (HR): 2.43; 95% CI: 1.13–5.62, P=0.024; HR: 0.21; 95% CI: 0.083–0.57, P=0.002, respectively). Nomograms predicting 3- and 5-year OS were established that performed well (concordance index (c-indexes) of 0.636, 95% CI: 0.549–723) for OS. For MAC and SRC disease, a greater proportion of young patients present with advanced disease, and the prognosis for young SRC patients is poorer than MAC. Furthermore, preoperative CEA levels and cycles of adjuvant CT seem to independently affect the OS in this patient population.

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.

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.

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