scholarly journals Krukenberg Tumor: A Review of Prognostic Factors and Management

2020 ◽  
pp. 1-4
Author(s):  
Adrian Murillo Zolezzi
Keyword(s):  
Abdominal Mass ◽  
Treatment Strategies ◽  
Signet Ring Cell ◽  
Current Evidence ◽  
Primary Ovarian Cancer ◽  
Signet Ring ◽  
Common Clinical Presentation ◽  
Ring Cell ◽  
Krukenberg Tumors ◽  
Worse Prognosis

Aim: This review aims to summarize current evidence on Krukenberg Tumors (KT), addressing the main prognostic determinants and its’ management. Background: Krukenberg Tumors are rare metastatic tumors of the ovary. They were initially described by Friederich Ernst Krukenberg in 1896. They arise from extra-ovarian primary signet-ring cell carcinomas, being the gastrointestinal tract the most common site of origin. The most common clinical presentation of KT is an abdominal mass or discomfort in a premenopausal 40 to the 50-year-old woman. The prognosis is extremely poor compared to primary ovarian cancer. Results: Overall survival may vary significantly according to the choice and timing of treatment. The effective treatment strategies for KT are still controversial. However, therapeutic options include surgical resection as the mainstay of treatment when possible and the application of different Chemotherapy (CT) regimens. Conclusions: Several factors negatively affect prognosis: an incomplete metastasectomy, extensive disease at diagnosis and the origin of the tumor are the main factors that most authors agree incur in a worse prognosis. KT’s optimal therapeutic strategies are still a matter of debate, raising the need for more studies to achieve consensus.

scholarly journals Intramucosal Signet Ring Cell Gastric Cancer Diagnosed 15 Months after the Initial Endoscopic Examination

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Keisuke Taniuchi ◽  
Koji Ookawauchi ◽  
Kento Kumon ◽  
Tatsuaki Sumiyoshi ◽  
Jun Iwata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Distal Gastrectomy ◽  
Immunohistochemical Analysis ◽  
Endoscopic Examination ◽  
Signet Ring Cell ◽  
P53 Mutations ◽  
Ki 67 ◽  
Signet Ring ◽  
Ring Cell ◽  
Worse Prognosis

The size and shape of intramucosal signet ring gastric cancer in this case remained endoscopically unchanged for 15 months. Laparoscopy-assisted distal gastrectomy was performed, and immunohistochemical analysis revealed Ki-67 and p53 mutations to be negative in this case. Signet ring gastric cancer has long been thought to confer a worse prognosis than other forms of gastric cancer; however, our case did not progress to advanced gastric cancer for 15 months.

Signet ring cell cancer: Harbinger of doom?

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 10-10
Author(s):  
Sharven Taghavi ◽  
Senthil N. Jayarajan ◽  
Adam Davey ◽  
Alliric Isaac Willis
Keyword(s):  
Cell Cancer ◽  
Tumor Grade ◽  
Signet Ring Cell ◽  
Male Predominance ◽  
Asian Race ◽  
Signet Ring ◽  
Ring Cell ◽  
Nodal Spread ◽  
Worse Prognosis ◽  
The U.S

10 Background: Signet ring cell cancer (SRC) is associated with worse prognosis. However, studies in Asia have questioned this idea. Our aim is to determine differences in presentation and outcomes between SRC and gastric adenocarcinoma (AC) to establish if SRC conveys worse prognosis in the U.S. Methods: NCI SEER was used to analyze differences in presentation and outcomes of SRC and AC from 2004−2007. Results: 10,886 gastric cancers included 2,872 SRC and 8,014 AC. SRC presented younger (62.0 vs 68.9 years, p<0.001) and less in males (53.7 vs 68.0%, p<0.001). SRC were more likely Asian (16.5 vs 13.5%) or Hispanic (23.3 vs 14.9%) and less Black (10.7 vs 11.5%) or White (71.8 vs 74.1%); p<0.001. SRC was more likely to be T-3 or T-4 (46.0 vs 33.8%), have nodal spread (72.5 vs 62.0%), and metastases (29.0 vs 24.1%); p<0.001. SRC was more likely lower stomach (30.6 vs 24.6%) or body (30.8 vs 21.6%) and less upper stomach (24.7 vs 46.9%); p<0.001. SRC more often overlapped regions (13.9 vs 6.9%, p<0.001). SRC was associated with mortality (HR 1.07, CI 1.01−1.14, p=0.017) and decreased median survival (12.0 vs. 13.0 months, p=0.034). Multivariate analysis stratified by AJCC stage and radiation found SRC was not independently associated with mortality (HR 1.04, CI 0.98−1.11, p=0.195). Mortality was associated with age (HR 1.01, CI 1.01−1.01, p=0.001), Black race (HR 1.11, CI 1.02−1.21, p=0.013), and tumor grade ( table ). Survival was associated with Asian race (HR 0.88, CI 0.81−0.95, p=0.001) and surgery (HR 0.21, CI 0.19−0.22, p=0.001). Conclusions: In the U.S., SRC differs from AC in presentation with younger age, less male predominance, greater tumor extent, metastases, and Asian or Hispanic ethnicity. Survival for SRC is associated with Asian race and surgical resection. Overall, SRC survival is less than AC. However, adjusted for stage at presentation, SRC does not portend a worse prognosis. [Table: see text]

Prognostic implications of signet ring cell histology in esophageal adenocarcinoma: A SEER database analysis

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4067-4067
Author(s):  
Saikrishna S. Yendamuri ◽  
Miriam Huang ◽  
Usha Malhotra ◽  
Graham Walter Warren ◽  
Paul Bogner ◽  
...  
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Surgical Resection ◽  
Multivariate Analyses ◽  
Signet Ring Cell ◽  
Clinical Impression ◽  
Seer Database ◽  
Signet Ring ◽  
Ring Cell ◽  
Prognostic Implications ◽  
Worse Prognosis

4067 Background: Signet ring cell esophageal adenocarcinoma histology has been difficult to study in a single institution series because of its relative rarity, yet has an anecdotal reputation for poor prognosis. We examined the Surveillance Epidemiology and End Results (SEER) database to assess the prognostic implications of this esophageal adenocarcinoma subtype. Methods: All patients with esophageal adenocarcinoma in the SEER database from 2004 – 2009 were included. Characteristics of patients with signet ring cell histology were compared to those without it. Univariate and multivariate analyses examining the relationship of signet ring cell histology with overall survival (censored at 72 months) were performed in all patients, as well as those undergoing surgical resection. Results: 597 of 11,838 (5%) study patients had signet ring cell histology. Patients with signet ring cell histology were similar in age, race, and gender distribution, but had a higher grade (p<0.001) and higher stage (p<0.001) at diagnosis. In both all-comers as well as those undergoing surgical resection, univariate analyses showed a worse survival in patients with signet ring cell esophageal cancer (HR = 1.24; 95% CI 1.13-1.37 and HR = 1.57; 95% CI 1.29-1.92 respectively). In multivariate analyses adjusting for age, gender, grade, stage, and race, patients with signet ring cell cancer had a worse prognosis than those with non-signet ring cell adenocarcinoma (HR = 1.20; 95% CI 1.09 -1.33). In surgically resected patients, this remained a trend, but did not reach statistical significance (HR = 1.16; 95% CI 0.94-1.42). Conclusions: This large study of esophageal adenocarcinoma confirms the clinical impression that signet ring cell variant of adenocarcinoma is associated with an advanced stage at presentation and a worse prognosis independent of stage of presentation.

scholarly journals Prognoses of different pathological subtypes of colorectal cancer at different stages: A population-based retrospective cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaoli Wu ◽  
Han Lin ◽  
Shaotang Li
Keyword(s):  
Colorectal Cancer ◽  
Treatment Strategies ◽  
Population Based ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Younger Age ◽  
Signet Ring ◽  
Ring Cell ◽  
Pathological Subtypes ◽  
Cause Specific Survival

Abstract Background Whether the prognoses of different pathological subtypes of colorectal cancer (CRC) at different stages are distinct is unclear. Methods We extracted data on all cases of CRC from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. The incidence of different pathological subtypes, clinical characteristics, and five-year overall survival (OS) and cause-specific survival (CSS) were analyzed. Results A total of 384,996 cases diagnosed as adenocarcinoma (AC), mucinous adenocarcinoma (MAC), and signet ring cell carcinoma (SRCC) were included in this analysis. Compared with AC, MAC and SRCC were more likely to reach T4, N2, M1, stages III and IV, and grades III and IV, and patients were generally of a younger age (P < 0.001). Compared with those with AC, patients with MAC and SRCC showed poorer OS (50.6 and 26.8% vs. 60.2%, P < .001), with corresponding HR values of 1.238 (95% CI, 1.213–1.263, P < .001) and 1.592 (95% CI, 1.558–1.627, P < .001), respectively. The MAC and SRCC groups also showed poorer overall CCS (60.9 and 32.5% vs. 67.8%, P < .001), with corresponding HR values of 1.271 (95% CI, 1.242–1.302, P < .001) and 1.724 (95% CI, 1.685–1.765, P < .001), respectively. Compared with patients with AC, those with MAC showed poor OS at every stage and poor CSS at every stage except stage II (P < .05), while patients with SRCC revealed poor OS and CSS at every stage except stage 0 (P < .05). Conclusions Patients of different pathological subtypes minimally differed at early stages. However, patients with AC have significantly better prognoses in advanced CRC (stages III and IV) than those with MAC or SRCC. Distinct treatment strategies should be applied depending on a particular histological subtype in advanced CRC.

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