Differential Prognostic Implications of Gastric Signet Ring Cell Carcinoma: Stage Adjusted Analysis From a Single High-volume Center in Asia

Chon, Hong Jae MD^*,†; Hyung, Woo Jin MD, PhD^‡; Kim, Chan MD, PhD^*; Park, Sohee PhD^§; Kim, Jie-Hyun MD^||; Park, Chan Hyuk MD^¶; Ahn, Joong Bae MD, PhD^**; Kim, Hyunki MD^††; Chung, Hyun Cheol MD, PhD^**; Rha, Sun Young MD, PhD^**; Noh, Sung Hoon MD, PhD^‡; Jeung, Hei-Cheul MD, PhD^||

Annals of Surgery: May 2017 - Volume 265 - Issue 5 - p 946–953

doi: 10.1097/SLA.0000000000001793

Original Articles

Objective: The aim of this study was to analyze the clinicopathologic characteristics and prognosis of signet ring cell carcinoma (SRC) according to disease status (early vs advanced gastric cancer) in gastric cancer patients.

Results: SRC patients have younger age distribution and female predominance compared with other histologic subtypes. Notably, the distribution of T stage of SRC patients was distinct, located in extremes (T1: 66.2% and T4: 20%). Moreover, the prognosis of SRC in early gastric cancer and advanced gastric cancer was contrasting. In early gastric cancer, SRC demonstrated more favorable prognosis than WMD after adjusting for age, sex, and stage. In contrast, SRC in advanced gastric cancer displayed worse prognosis than WMD. As stage increased, survival outcomes of SRC continued to worsen compared with WMD.

Conclusions: Although conferring favorable prognosis in early stage, SRC has worse prognostic impact as disease progresses. The longstanding controversy of SRC on prognosis may result from disease status at presentation, which leads to differing prognosis compared with tubular adenocarinoma.

http://journals.lww.com/annalsofsurgery/Fulltext/2017/05000/Differential_Prognostic_Implications_of_Gastric.17.aspx