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Signet Ring Cell Gastric Carcinoma: Clinical Epidemiology and Outcomes in a Predominantly Latino County Hospital Population

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Abstract

Background

Gastric signet ring cell carcinoma (GSRC) is a rare but increasingly prevalent tumor histotype whose clinical features and natural history are poorly understood, particularly in the USA and minorities.

Aims

To examine the occurrence, clinico-demographic characteristics, oncologic features, treatment, and outcomes of GSRC in a predominantly minority county hospital setting and benchmark them against data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program.

Methods

We queried biopsy-proven GSRC cases at a Los Angeles County hospital, from 2004 to 2017. Clinical characteristics, treatment, and survival data were collected and compared to SEER data.

Results

We identified 63 patients with GSRC. Compared to SEER, our cohort was significantly younger (52.6 vs. 63.5 years, p < 0.01), Hispanic/Latino predominant (81% vs. 20%, p < 0.01), had higher overall stage (86% vs. 69% with stage III/IV, p < 0.01), and more frequent node involvement (89% vs. 49%, p < 0.01). Lower tumor stage, Helicobacter pylori positivity, and surgical intervention were associated with significantly longer median survival (all p < 0.05), which was similar in our study compared to SEER (median 12.6 vs. 9.0 months, p = 0.26).

Conclusions

Patients with GSRC within the Los Angeles County population have different clinical characteristics compared to what has been reported in SEER. Our cohort was younger, and despite having more advanced disease, did not have shorter survival. Further study is needed to better identify protective and risk factors in this population and improve understanding of the etiopathogenesis and natural history of this malignancy.

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Acknowledgments

The authors would like to thank the late Dr. Jeffrey M. Miller for his assistance with data interpretation and the UCLA Clinical and Translational Science Institute (NIH National Center for Advancing Translational Science Grant UL1TR001881) for providing statistical and analytical support.

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Authors and Affiliations

  1. UCLA-Olive View Internal Medicine Residency Program, Sylmar, CA, USA

    Brian M. Fung, Mital Patel & Neha Patel

  2. Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USA

    Arleen F. Brown

  3. Department of Pathology and Laboratory Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USA

    Nora L. Ostrzega

  4. David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Brian M. Fung, Mital Patel, Neha Patel, Arleen F. Brown, Nora L. Ostrzega & James H. Tabibian

  5. Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, 14445 Olive View Dr., 2B-182, Sylmar, CA, 91342, USA

    James H. Tabibian

Authors
  1. Brian M. Fung
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Contributions

BMF, MP, NP, and JHT designed the study; BMF, MP, NP, and NLO collected data; BMF, MP, NP, and JHT analyzed results; BMF drafted the manuscript and tables; JHT and AFB provided revisions of the manuscript; all approved the final manuscript.

Corresponding author

Correspondence to James H. Tabibian.

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The authors declare that they have no conflict of interest.

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Fung, B.M., Patel, M., Patel, N. et al. Signet Ring Cell Gastric Carcinoma: Clinical Epidemiology and Outcomes in a Predominantly Latino County Hospital Population. Dig Dis Sci 66, 1240–1248 (2021). https://doi.org/10.1007/s10620-020-06341-z

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  • DOI: https://doi.org/10.1007/s10620-020-06341-z

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