Does signet ring cell carcinoma component signify worse outcomes for patients with colorectal cancer?

Optimal neoadjuvant strategy for signet ring cell carcinoma of the rectum—Is TNT the solution?

“…A little less than two‐third of patients that reached the stage of surgical exploration had R0 resections and over 25% had progression on neoadjuvant therapy with similar proportions irrespective of the strategy used. The peritoneum was the most common site of progression (60%) and is a function of the biology of signet ring tumors 4,5,23 . Similar were the recurrence patterns occurring largely in the peritoneum or locally.…”

“…Multiple prior studies have demonstrated adverse outcomes with a signet component of <50% also thus justifying their inclusion. 1,2,5 Although we intended to compare CTRT against SCRT and chemotherapy, more than half of CTRT patients also received additional chemotherapy. This is not strictly a drawback as it reflects the real-world situation of non-responding tumors with persistent involvement of mesorectal fascia where in anticipation of downstaging further chemotherapy was delivered.…”

“…Signet ring cell cancers (SRCCs) of the rectum are a rare histologic subtype constituting 1%–4% 1,2 of all rectal cancers. They are known to be associated with a peculiarly worse prognosis, younger age at presentation, advanced stage, and a very high predilection for peritoneal metastasis 3–5 . Besides these adverse characteristics, mucinous and in particular signet ring components have a poor response to neoadjuvant therapies 6 .…”

Signet-ring Cell Carcinoma Component as an Indicator of Anaplastic Lymphoma Kinase Mutations in Colorectal Cancer

“…In NSCLC, a solid signet-ring cell pattern and a mucinous cribriform pattern are present, at least focally, in the majority (78%) of ALK-positive tumors, but these are rare (1%) in ALK-negative tumors [8]. Thus, we propose that an evaluation of the presence of the SRCC component via histology might help in identifying candidate cases for ALK testing in CRC, considering that SRCC is a rare CRC subtype [14], accounting for 1%-2.4% of CRC cases [15]. By definition, signet-ring cell CRC is defined by the presence of at least 50% of the SRCC component [14].…”

Clinical impact of non-predominant histopathological subtypes on the long-term prognosis of colorectal cancer patients in Japan

“…Recently, in addition to and signet-ring cell carcinoma. CAC classical adenocarcinoma, M-l mucinous adenocarcinoma < 50%, M-h mucinous adenocarcinoma ≥ 50%, P-l poorly differentiated adenocarcinoma < 50%, P-h poorly differentiated adenocarcinoma ≥ 50%, S-l signet-ring cell carcinoma < 50%, S-h signet-ring cell carcinoma ≥ 50% [14,16,17]. This study not only revealed the postoperative long-term survival outcome in patients with non-predominant histopathological CRC subtypes, but also the proportion of histopathological subtypes in patients with CRC and clarified the relationship between the predominant histopathological CRC subtypes and clinicopathologic findings (Table 1).…”