The Predictive and Guidance Value of Signet Ring Cell Histology for Stage II/III Colon Cancer Response to Chemotherapy

Jiang, Huici; Shao, Dongxuan; Zhao, Peiyu; Wu, Yupeng

doi:10.3389/fonc.2021.631995

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…The most recent systematic evaluation analysis concluded that chemotherapy had different effects on OS in triple-negative breast cancer patients with different tissue subtypes (6). Jiang et al demonstrated that the efficacy of chemotherapy was not statistically significant for signet ring cell cancer (SRCC) and adenocarcinoma (AD) in stage II colon cancer, whereas chemotherapy for stage III SRCC significantly reduced the risk of cancer-specific death (7). Another study found that radiotherapy for urothelial carcinoma improved OS in patients with AD and transitional cell carcinoma, but had no significant effect on squamous cell carcinoma (8).…”

Section: Introductionmentioning

confidence: 99%

Based on the Development and Verification of a Risk Stratification Nomogram: Predicting the Risk of Lung Cancer-Specific Mortality in Stage IIIA-N2 Unresectable Large Cell Lung Neuroendocrine Cancer Compared With Lung Squamous Cell Cancer and Lung Adenocarcinoma

et al. 2022

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BackgroundThe purpose of this study is to predict overall survival (OS) and lung cancer-specific survival (LCSS) in patients with stage IIIA-N2 unresectable lung squamous cell cancer (LUSC), lung adenocarcinoma (LUAD), and large cell neuroendocrine cancer (LCNEC) by constructing nomograms and to compare risk and prognostic factors affecting survival outcomes in different histological subtypes.MethodsWe included 11,505 unresectable NSCLC patients at stage IIIA-N2 between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Moreover, competition models and nomograms were developed to predict prognostic factors for OS and LCSS.ResultsAnalysis of the SEER database identified 11,505 NSCLC patients, of whom 5,559 (48.3%) have LUAD, 5,842 (50.8%) have LUSC, and 104 (0.9%) have LCNEC. Overall, both OS and LCSS were significantly better in stage IIIA-N2 unresectable LUAD than in LCNEC, while there was no statistically significant difference between LUSC and LCNEC. Age, gender, T stage, chemotherapy, and radiotherapy were significantly associated with OS rates in LUAD and LUSC. However, chemotherapy was the only independent factor for LCNEC (p < 0.01).From competitive risk models, we found that older age, larger tumors, non-chemotherapy and non-radiotherapy were associated with a increased risk of death from LUAD and LUSC. Unlike prognostic factors for OS, our study showed that both chemotherapy and radiotherapy were all LCNEC-specific survival factors for both LCSS and non-LCSS LCNEC.ConclusionOur study reports that unresectable patients with stage IIIA-N2 LCNEC and LUSC have worse LCSS than LUAD. The study’s first prognostic nomogram constructed for patients with unresectable stage IIIA-N2 NSCLC can accurately predict the survival of different histological types, which may provide a practical tool to help clinicians assess prognosis and stratify these prognostic risks to determine which patients should be given an optimized individual treatment strategy based on histology.

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Section: Introductionmentioning

confidence: 99%

Based on the Development and Verification of a Risk Stratification Nomogram: Predicting the Risk of Lung Cancer-Specific Mortality in Stage IIIA-N2 Unresectable Large Cell Lung Neuroendocrine Cancer Compared With Lung Squamous Cell Cancer and Lung Adenocarcinoma

et al. 2022

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Elevated postoperative carcinoembryonic antigen guides adjuvant chemotherapy for stage II colon cancer: a multicentre cohort retrospective study

Pu,

Yang,

Liu

et al. 2024

Sci Rep

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Most clinical doctors rely on high-risk factors recommended by guidelines to decide whether to undergo adjuvant chemotherapy for stage II colon cancer. However, these high-risk factors do not include postoperative carcinoembryonic antigen (CEA). This study aims to explore the elevation of postoperative CEA as a risk factor, in addition to other high-risk factors, to guide adjuvant chemotherapy for patients with stage II colon cancer. A retrospective analysis was conducted on stage II colon cancer patients who underwent curative surgery at Yunnan Cancer Hospital and The Sixth Affiliated Hospital of Sun Yat-Sen University from April 2008 to January 2019. Patients were classified into three groups based on high-risk factors recommended by guidelines and postoperative CEA levels: low-risk with normal postoperative CEA, low-risk with elevated postoperative CEA and high-risk. COX regression analysis was used to identify independent prognostic factors affecting patients’ recurrence free survival (RFS). The Kaplan–Meier method was used to create the patients’ RFS curve. The restricted cubic spline (RCS) curve was used to assess the correlation between postoperative CEA and RFS on a continuous scale. Among 761 patients, there were 444 males (62.01%), with a median [IQR] age of 58.0 (18.0–88.0) years. A group of 425 high-risk patients had a 3-year RFS of 82.2% (95% CI 78.5–86.1%), while a group of 291 low-risk patients had a 3-year RFS of 89.7% (95% CI 86.1–93.5%). There was a statistically significant difference between the two groups (HR 1.83; 95% CI 1.22–2.74; P = 0.0067). Among them, the 3-year RFS of 261 low-risk patients with normal postoperative CEA was 93.6% (95% CI 90.5–96.8%), while the 3-year RFS of 30 low-risk patients with elevated postoperative CEA was 57.3% (95% CI 41.8–71.4%). There was a significant difference compared to the 3-year RFS of 425 high-risk patients (overall log-rank P < 0.0001). The multivariate analysis adjusted by the COX proportional hazards model showed that low-risk patients with elevated postoperative CEA patients (HR 14.95, 95% CI 4.51–49.63, P < 0.0001) was independently associated with a 3-year RFS. The restricted cubic spline model showed that in stage II colon cancer patients with tumor diameter > 1.955 ng/mL, the risk of postoperative recurrence increased with increasing postoperative CEA levels. Patients with elevated postoperative CEA levels have a significantly increased risk of recurrence. They should be included as high-risk factors to guide adjuvant chemotherapy for stage II colon cancer.

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An Insight into the Peculiarities of Signet-Ring Cell Carcinoma of the Colon – a Narrative Review

Farcaș,

Voskuil-Galoș

2024

JMRO

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Background: Signet-ring cell carcinoma of the colon (SRCC) is a rare and distinct form of colon cancer associated with a poor prognosis. Despite the rapid advancement of personalized cancer treatments, there is currently no recommended specific treatment for this histological subtype. Materials and Methods: In this literature review, we explored and described the features that distinguish SRCC from other forms of colorectal cancer, focusing on clinical presentation, preoperative workup, and treatment. Results: One of the aspects that makes SRCC unique is that it is detected more often in the ascending vs other parts of the colon, regardless of age and gender. As a result, patients, unfortunately, present with a more advanced stage than other locations upon the initial diagnosis.Imaging techniques and tumor markers alone often fall short of revealing the extent of a tumor, and curative surgery procedures are rare. Neoadjuvant therapy in SRCC is currently recommended only in the context of a clinical trial. Adjuvant chemotherapy, on the other hand, appears promising in improving survival, especially in the stage III subgroup. SRCC have a higher incidence of BRCA1 and BRAF gene mutations when compared to adenocarcinomas, alongside to an increase in microsatellite instability. These particularities suggest that a targeted therapeutic approach may sometimes be considered. Conclusion: Given its specific clinical characteristics and poor survival outcomes, SRCC should be considered a distinct colon cancer entity. Although its rarity makes prospective trials difficult, a timely diagnosis and a correct treatment decision-making algorithm is important.

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The Predictive and Guidance Value of Signet Ring Cell Histology for Stage II/III Colon Cancer Response to Chemotherapy

Cited by 3 publications

References 28 publications

Based on the Development and Verification of a Risk Stratification Nomogram: Predicting the Risk of Lung Cancer-Specific Mortality in Stage IIIA-N2 Unresectable Large Cell Lung Neuroendocrine Cancer Compared With Lung Squamous Cell Cancer and Lung Adenocarcinoma

Based on the Development and Verification of a Risk Stratification Nomogram: Predicting the Risk of Lung Cancer-Specific Mortality in Stage IIIA-N2 Unresectable Large Cell Lung Neuroendocrine Cancer Compared With Lung Squamous Cell Cancer and Lung Adenocarcinoma

Elevated postoperative carcinoembryonic antigen guides adjuvant chemotherapy for stage II colon cancer: a multicentre cohort retrospective study

An Insight into the Peculiarities of Signet-Ring Cell Carcinoma of the Colon – a Narrative Review

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