Incidence, Survival, and Predictors of Lymph Node Involvement in Early-Stage Gastric Signet Ring Cell Carcinoma in the US

Pokala, Sridevi K.; Zhang, Chao; Gamboa, Anthony; Cristofaro, Sarah; Keilin, Steven; Cai, Qiang; Willingham, Field F.

doi:10.1007/s11605-017-3500-4

Cited by 23 publications

(20 citation statements)

References 24 publications

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“…With sufficient subsequent analytical power, this enables researchers to make meaningful conclusions beyond that provided in case reports or case series studies. Most of our knowledge about the demographics and prognosis of SRCCs comes from the summaries of population-level registries of gastric and colon cancers [ 10 , 11 ], with supplementation from case series on SRCCs from other sites. However, there is no study that systematically and robustly compares SRCCs by site to matching nonvariant cases.…”

Section: Introduction—overview Of Signet Ring Cell Adenocarcinomasmentioning

confidence: 99%

Epidemiology of Signet Ring Cell Adenocarcinomas

Benesch

Mathieson

2020

Cancers

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Signet ring cell adenocarcinomas (SRCCs) are a rare histological subtype of adenocarcinomas with a poor prognosis, typically due to advanced disease at diagnosis. A signet ring cell, mimicking its moniker, contains abundant intracytoplasmic mucin that pushes the nucleus to the periphery. In these cancers, this cell feature comprises more than 50% of the tumor. Despite predilection for the gastrointestinal tract, and in particular the stomach, primary SRCCs are also described in other sites, typically in case reports. This literature, however, lacks a standardized overview of the SRCC disease entity. Using a retrospective cohort approach, we summarize the clinicodemographic and mortality outcomes of SRCCs in thirteen primary sites, comprising 95% of all SRCCs in the Surveillance, Epidemiology, and End Results Program (SEER), a population-level cancer database covering nearly one-third of the United States population. SRCCs general trends compared to matching nonvariant adenocarcinomas are earlier age of onset, with initial presentation favoring higher rates of regional or distant disease presentation and poor tumor differentiation. After multivariable analysis, SRCCs typically have worse overall survivals, but substantial variances exist depending on tumor location. Identifying SRCCs at earlier disease stages is likely the single most important intervention to improving outcomes for these patients.

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Section: Introduction—overview Of Signet Ring Cell Adenocarcinomasmentioning

confidence: 99%

Epidemiology of Signet Ring Cell Adenocarcinomas

Benesch

Mathieson

2020

Cancers

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“…In a study carried out by Pokala et al, gastric cancer with SRC histology was found to be correlated with good prognosis at an early-disease stage and poor prognosis at an advanced disease stage (18). Postlewait et al identified no statistical difference between stage I-III gastric cancer patients with SRC and non-SRC histology in terms of survival rate (P=0.777, P=0.190, and P=0.756, respectively).…”

Section: Discussionmentioning

confidence: 96%

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

Uzun

Senger

Gülmez

et al. 2020

ircmj

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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.

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“…Pokala et al reported that the incidence of metastatic nodes for 244 T1a GSRC patients with a significantly associated tumor size of <1 cm and <2 cm was 2.7% and 5.4%, respectively. 33 Lee et al reported that the incidence of lymph node metastasis was 1.9% with intramucosal cancer and proposed that early-stage GSRC can be treated through endoscopic resection if the diameter is smaller than 25 mm and intramucosal, excluding lymphatic vascular metastasis. 34,35 Wang et al reported that the overall rate of lymph node metastasis in early-stage GSRC was 10.3% and no lymph node metastasis was observed in tumors <20mm without lymphatic vascular metastasis.…”

Section: Management Of Early and Locally Advanced Gsrc Endoscopic Trementioning

confidence: 99%

<p>Gastric Signet Ring Cell Carcinoma: Current Management and Future Challenges</p>

Zhu

et al. 2020

CMAR

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Recent advances in the epidemiology, pathology, molecular mechanisms, and combined modality therapy (CMT) fields have shown that gastric signet ring cell carcinoma (GSRC) should be considered a distinct cancerous entity. Clinical management of this cancer is challenging, with chemoradioresistance and poor outcomes in advanced stages. Pathological and molecular sets of GSRC demonstrate different features of poor cohesion and differentiation according to the WHO, Japanese Gastric Cancer Association, and Laurén classifications. These features also result in poor response to adjuvant and neoadjuvant chemoradiotherapy. Certain studies of GSRC showed the disputed effectiveness of hyperthermic intraperitoneal chemotherapy and immunotherapy. Our aim was to discuss how an improved understanding of these therapeutic benefits may provide better treatment selection for patients, and therefore improve survival. The challenges in the new understanding of GSRC in routine practice and pathology, and the current limitations of treatment will also be discussed.

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Incidence, Survival, and Predictors of Lymph Node Involvement in Early-Stage Gastric Signet Ring Cell Carcinoma in the US

Cited by 23 publications

References 24 publications

Epidemiology of Signet Ring Cell Adenocarcinomas

Epidemiology of Signet Ring Cell Adenocarcinomas

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

<p>Gastric Signet Ring Cell Carcinoma: Current Management and Future Challenges</p>

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