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

Authors
 Hong Jae Chon  ;  Woo Jin Hyung  ;  Chan Kim  ;  Sohee Park  ;  Jie-Hyun Kim  ;  Chan Hyuk Park  ;  Joong Bae Ahn  ;  Hyunki Kim  ;  Hyun Cheol Chung  ;  Sun Young Rha  ;  Sung Hoon Noh  ;  Hei-Cheul Jeung 
Citation
 Annals of Surgery, Vol.265(5) : 946-953, 2017 
Journal Title
 Annals of Surgery 
ISSN
 0003-4932 
Issue Date
2017
MeSH
Adenocarcinoma/mortality ; Adenocarcinoma/pathology* ; Adenocarcinoma/surgery ; Adult ; Aged ; Asia ; Biopsy, Needle ; Carcinoma, Signet Ring Cell/mortality ; Carcinoma, Signet Ring Cell/pathology* ; Carcinoma, Signet Ring Cell/surgery ; Cause of Death* ; Cohort Studies ; Disease Progression ; Disease-Free Survival ; Female ; Gastrectomy/methods* ; Gastrectomy/mortality ; Hospitals, High-Volume ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness/pathology ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery* ; Neoplasm Staging Prognosis ; Proportional Hazards Models ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery ; Survival Analysis ; Treatment Outcome
Keywords
gastric cancer ; prognostic factor ; signet ring cell carcinoma
Abstract
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. BACKGROUND: The prognostic implication of gastric SRC remains a subject of debate. METHODS: A retrospective analysis was performed using the clinical records of 7667 patients including 1646 SRC patients who underwent radical gastrectomy between 2001 and 2010. A further analysis was also performed after dividing patients into three groups according to histologic subtype: SRC, well-to-moderately differentiated (WMD), and poorly differentiated adenocarcinoma. 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.
Files in This Item:
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DOI
10.1097/SLA.0000000000001793
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
김지현(Kim, Jie-Hyun) ORCID logo https://orcid.org/0000-0002-9198-3326
김현기(Kim, Hyunki) ORCID logo https://orcid.org/0000-0003-2292-5584
노성훈(Noh, Sung Hoon) ORCID logo https://orcid.org/0000-0003-4386-6886
라선영(Rha, Sun Young) ORCID logo https://orcid.org/0000-0002-2512-4531
박소희(Park, So Hee) ORCID logo https://orcid.org/0000-0001-8513-5163
안중배(Ahn, Joong Bae) ORCID logo https://orcid.org/0000-0001-6787-1503
전홍재(Chon, Hong Jae)
정현철(Chung, Hyun Cheol) ORCID logo https://orcid.org/0000-0002-0920-9471
정희철(Jeung, Hei Cheul) ORCID logo https://orcid.org/0000-0003-0952-3679
형우진(Hyung, Woo Jin) ORCID logo https://orcid.org/0000-0002-8593-9214
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/153871
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