The Impact of Perioperative Chemotherapy on Survival in Patients With Gastric Signet Ring Cell Adenocarcinoma

Messager, Mathieu; Lefèvre, Jérémie H.; Pichot-Delahaye,; Souadka, Amine; Piessen, Guillaume; Mariette, C.

doi:10.1097/sla.0b013e3182352647

Cited by 186 publications

(174 citation statements)

References 24 publications

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“…Similarly, postoperative chemotherapy was efficient in the non-SRC group but did not impact on survival in the SRC group, whereas preoperative chemotherapy was associated with poorer survival in the non-SRC group but had no significant impact in the SRC group. This latter observation contrasts with results from a previous study by our group, which identified preoperative chemotherapy as an adverse prognostic factor for overall survival in SRC adenocarcinoma patients [6]. This discrepancy could be partly due to the inclusion of tumors of the esophagogastric junction in the first study [56].…”

Section: Discussioncontrasting

confidence: 56%

“…Although the global incidence of gastric adenocarcinoma has declined in the last few years, the incidence of the signet-ring cell (SRC) type increased in the USA between 1973 and 2000 from 0.1 to 1.4 cases per 100,000 persons [2], and represents 3.5 % to 45.4 % of gastric carcinoma in recent publications [3][4][5][6][7][8][9][10][11][12]. According to the World Health Organization (WHO) classification, SRC carcinoma is an adenocarcinoma in which more than 50 % of the tumor consists of isolated or small groups of malignant cells containing intracytoplasmic mucins [13].…”

Section: Introductionmentioning

confidence: 99%

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Is signet-ring cell carcinoma a specific entity among gastric cancers?

et al. 2015

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Background The prognosis and chemoresistance of signet-ring cell (SRC) gastric adenocarcinoma have been reported and debated, and the utility of perioperative chemotherapy for such a tumor has been questioned. This study was performed to assess the impact of the SRC type on survival following resection of gastric adenocarcinoma, and to assess whether the prognostic factors (including perioperative chemotherapy) for non-SRC adenocarcinoma differed from those for SRC adenocarcinoma. Methods 1799 cases of adenocarcinoma that were consecutively treated from 1997 to 2010 in 19 French centers by subtotal or total gastrectomy were included in a retrospective study. A D2 lymphadenectomy was performed for antropyloric tumors, and a modified D2 for upper tumors. SRC adenocarcinoma was diagnosed based on the presence of isolated carcinoma cells containing mucin. Results A total gastrectomy was performed in 979 (54.4 %) patients. SRC adenocarcinoma was diagnosed in 899 (50 %) patients. Patients with an SRC tumor were more frequently female, younger, and malnourished, had lower ASA scores, and had larger tumors than non-SRC patients. Median survival in patients with non-SRC carcinoma was 51 months, as compared to 26 months in patients with SRC carcinoma (p \ 0.001). At multivariate analysis, SRC type remained an independent adverse prognostic factor (HR = 1.182). Factors that were prognostic in the SRC subgroup but not in the non-SRC subgroup were age [60 years, linitis, and involvement of adjacent organs. In contrast to non-SRC tumors, pre-and postoperative chemotherapy did not significantly impact on survival following resection of SRC adenocarcinoma. On behalf of the FREGAT (French Eso-GAstric Tumours) working group-FRENCH (Fédération de Recherche en Chirurgie).Electronic supplementary material The online version of this article (doi:10.1007/s10120-015-0564-2) contains supplementary material, which is available to authorized users. Conclusion In comparison to non-SRC adenocarcinoma, the SRC type has a worse prognosis, different prognostic factors, and is only poorly sensitive to perioperative chemotherapy. Non-SRC and SRC adenocarcinomas should be considered different entities in future therapeutic trials.

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Is signet-ring cell carcinoma a specific entity among gastric cancers?

et al. 2015

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“…Currently, both strategies are also being investigated prospectively in the CRITICS trial [59]. Additionally, a comparative French multicenter study suggested a worse outcome for patients with a signet ring cell type of gastric carcinoma after perioperative chemotherapy versus surgery [60]. Therefore, the Prodice-FFCD group started a randomized controlled trial of perioperative versus adjuvant therapy in these subtype patients [61].…”

Section: Discussionmentioning

confidence: 99%

International comparison of the German evidence-based S3-guidelines on the diagnosis and multimodal treatment of early and locally advanced gastric cancer, including adenocarcinoma of the lower esophagus

et al. 2014

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Background Clinical guidelines are essential in implementing and maintaining nationwide stage-specific diagnostic and therapeutic standards. In 2011, the first German expert consensus guideline defined the evidence for diagnosis and treatment of early and locally advanced esophagogastric cancers. Here, we compare this guideline with other national guidelines as well as current literature.Methods The German S3-guideline used an approved development process with de novo literature research, international guideline adaptation, or good clinical practice. Other recent evidence-based national guidelines and current references were compared with German recommendations.

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“…Piessen et al showed that the median survival was significantly lower for SRC patients (21 vs 44 months, p < 0.004), with higher rates of localized peritoneal carcinomatosis (p < 0.013) and lymph node involvement (p < 0.001) at diagnosis, lower R0 resection rate (p < 0.019) and earlier tumor relapse (p < 0.009), which was generally in a peritoneal carcinomatosis form (p < 0.011) [54]. Furthermore the SRC histology proved to be chemoresistant [55].…”

Section: Discussionmentioning

confidence: 94%

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

Chia

Seshadri

Képénékian³

et al. 2016

Pleura and Peritoneum

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Background: The current treatment of choice for peritoneal carcinomatosis from gastric cancer is systemic chemotherapy. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a new aggressive form of loco-regional treatment that is currently being used in pseudomyxoma peritoneii, peritoneal mesothelioma and peritoneal carcinomatosis from colorectal cancer. It is still under investigation for its use in gastric cancer. Methods: The literature between 1970 and 2016 was surveyed systematically through a review of published studies on the treatment outcomes of CRS and HIPEC for peritoneal carcinomatosis from gastric cancer. Results: Seventeen studies were included in this review. The median survival for all patients ranged from 6.6 to 15.8 months. The 5-years overall survival ranged from 6 to 31%. For patients with complete cytoreduction, the median survival was 11.2 to 43.4 months and the 5-years overall survival was 13 % to 23%. Important prognostic factors were found to be a low peritoneal carcarcinomatosis index (PCI) score and the completeness of cytoreduction.

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The Impact of Perioperative Chemotherapy on Survival in Patients With Gastric Signet Ring Cell Adenocarcinoma

Abstract: PCT provides no survival benefit in patients with gastric SRC. Clinical Trial.gov record: ADCI001, Clinical Trial.gov identifier NCT01249859.

Cited by 186 publications

References 24 publications

Is signet-ring cell carcinoma a specific entity among gastric cancers?

Is signet-ring cell carcinoma a specific entity among gastric cancers?

International comparison of the German evidence-based S3-guidelines on the diagnosis and multimodal treatment of early and locally advanced gastric cancer, including adenocarcinoma of the lower esophagus

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

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