Stage-stratified prognosis of signet ring cell histology in patients undergoing curative resection for gastric adenocarcinoma Journal Article
| Authors: | Bamboat, Z. M.; Tang, L. H.; Vinuela, E.; Kuk, D.; Gonen, M.; Shah, M. A.; Brennan, M. F.; Coit, D. G.; Strong, V. E. |
| Article Title: | Stage-stratified prognosis of signet ring cell histology in patients undergoing curative resection for gastric adenocarcinoma |
| Abstract: | Background: The prognosis of signet ring cell (SRC) gastric adenocarcinoma is regarded as poor, although studies addressing outcomes in relation to non-SRC tumors are conflicting. Our objective was to compare the survival of SRC tumors with stage-matched intestinal-type tumors in a cohort of Western patients. Methods: Review of a prospectively maintained database identified 569 patients undergoing curative resection (R0) from 1990 to 2009. Patients were divided into three histologic groups on the basis of the Lauren classification: SRC (n = 210), intestinal well- or moderately differentiated (WMD, n = 242) disease, and intestinal poorly differentiated (PD, n = 117) disease. Patient demographics, clinicopathologic features, and postoperative outcomes were determined. Stage-stratified disease-specific mortality was calculated and multivariate analysis performed. Results: When compared with WMD and PD tumors, SRC tumors were associated with younger age (63 years SRC vs. 71 years WMD and 72 years PD, p < 0.0001) and with female sex (58 % SRC vs. 40 % WMD and 40 % PD, p = 0.0003). Median follow-up was 115 months. Patients with stage Ia SRC lesions had a better 5-year disease-specific mortality compared with stage-matched intestinal-type tumors (0 % SRC vs. 8 % WMD and 24 % PD, p = 0.001). In contrast, SRC patients with stage III disease fared significantly worse (78 % SRC vs. 54 % WMD and 72 % PD, p = 0.001). On multivariate analysis, the risk of death from gastric cancer comparing all three groups was lowest for SRC in stage I and highest for SRC in stage III disease (stage III hazard ratio: SRC 1 vs. 0.47 WMD and 0.85 PD). Conclusions: When compared with intestinal-type tumors, SRC tumors at early stages are not necessarily associated with poor outcomes. © 2014 Society of Surgical Oncology. |
| Keywords: | adult; cancer survival; controlled study; aged; cancer surgery; survival rate; major clinical study; overall survival; clinical feature; histopathology; cancer adjuvant therapy; cancer patient; postoperative care; cancer staging; outcome assessment; follow up; cancer diagnosis; prospective study; disease association; cohort analysis; cell differentiation; cancer cell culture; cancer mortality; survival time; cancer cell; sex difference; hazard ratio; age distribution; cancer classification; stomach adenocarcinoma; intestine tumor; disease specific survival; signet ring carcinoma; cancer prognosis; human; male; female; article; curative cancer resection; gastric cancer specific mortality; lauren classification; signet ring cell; stage stratified prognosis |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 21 |
| Issue: | 5 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2014-05-01 |
| Start Page: | 1678 |
| End Page: | 1685 |
| Language: | English |
| DOI: | 10.1245/s10434-013-3466-8 |
| PROVIDER: | scopus |
| PUBMED: | 24394986 |
| DOI/URL: | |
| Notes: | Ann. Surg. Oncol. -- Export Date: 2 June 2014 -- CODEN: ASONF -- Source: Scopus |
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