Prognosis and value of preoperative radiotherapy in locally advanced rectal signet-ring cell carcinoma

Abstract

As well known, signet-ring cell carcinoma (SRCC) is a rare histological subtype of colorectal adenocarcinoma, which has been associated with poor prognosis and resistant to non-surgery therapy compared with common adenocarcinoma. In this study, we assessed the effect of preoperative radiotherapy (PRT) for locally advanced rectal SRCC in a large patient group from the Surveillance, Epidemiology, and End Results program (SEER, 1988–2011) database. SRCC was found in 0.9% (n = 622) rectal cancer (RC) patients in our study. In the PRT setting, SRCC had significantly worse cancer-specific survival than mucinous adenocarcinoma and nonmucinous adenocarcinoma patients (log-rank, P < 0.001). In terms of SRCC, stage III RC patients benefited from PRT (log-rank, P < 0.001) while stage II did not (P = 0.095). The multivariate Cox proportional hazard model showed that PRT was an independent benefit factor in stage III rectal SRCC patients (HR, 0.611; 95% CI, 0.407–0.919; P = 0.018). In conclusion, SRCC was an independent predictor of poor prognosis in stage III RC patients, but not in stage II. In the PRT setting of locally advanced RC, SRCC patients had significantly worse prognosis. PRT was an independent prognostic factor associated with improved survival in stage III rectal SRCC.

Prognostic significance of preoperative radiotherapy in stage II and III rectal cancer patients: A Strobe-compliant study of SEER 18 registries database (1988–2011)

“…Interestingly, in further multivariate survival analysis of prognostic factors stratified by tumor stages, which were rarely reported in previous studies, we found that except for old age, histological type of mucinous cancer, poor differentiation and single source of tumor served as independent predictors for worse survival in both stage II and III RC patients, in accordance with other analyses from SEER (1988-2011) and SEER (1973-2011) [15,26]. PRT as an independent predictor for better prognosis was only observed in stage III other than stage II, which was rarely reported before.…”

Chemotherapy is associated with increased survival from colorectal signet ring cell carcinoma with distant metastasis: A Surveillance, Epidemiology, and End Results database analysis

“…Thus, we strongly recommend future studies to reevaluate the effect of chemotherapy on patients with metastatic colorectal SRCC, in a larger population. Lastly, due to the limited patient number of SRCC patients who received radiotherapy, we could not evaluate the impact of radiotherapy on nonmetastatic or metastatic colorectal SRCC and only a few studies assessing the efficacy of radiotherapy alone or combined with chemotherapy in SRCC patients have been reported . Therefore, we also recommend further investigation on the role of radiotherapy in SRCC.…”

“…Further studies have found that many independent prognostic factors are associated with poor survival of SRCC, including age, sex, tumor size, tumor grade, and primary site . In addition, the treatment of colorectal SRCC patients has rapidly improved in recent years.…”

Factors associated with the survival of colorectal cancer in Mexico

“…The survival rate improved in patients with stage III colon cancer. 17 This study aimed to determine the probability of survival in patients with CRC and to identify the association between survival and low levels of schooling, low socioeconomic status, and location in a rural population, adjusting for the clinical and histologic stages of disease and the type of treatment.…”