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

 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 
 ANNALS OF SURGERY, Vol.265(5) : 946-953, 2017 
Journal Title
Issue Date
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
gastric cancer ; prognostic factor ; signet ring cell carcinoma
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.
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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
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Park, So Hee(박소희) ORCID logo https://orcid.org/0000-0001-8513-5163
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Chon, Hong Jae(전홍재)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Jeung, Hei Cheul(정희철) ORCID logo https://orcid.org/0000-0003-0952-3679
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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