Skip to main content

Advertisement

Log in

Prognostic Value of Gastric Signet Ring Cell Carcinoma: a Population-Based Propensity Score-Matched Analysis

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

The prognostic value of signet ring cell carcinoma in gastric cancer is still a point of discussion. This study aims to assess the impact of signet ring cell carcinoma on long-term survival of gastric cancer patients following resection. Patients undergoing surgical resection for gastric cancer between 2010 and 2015 were identified in the Surveillance, Epidemiology, and End Results database. Propensity score-matching analysis was utilized to assess the overall survival and disease-specific survival. Among the 6051 included patients, 1246 (20.6%) had signet ring cell carcinoma and 4805 (79.4%) had non-signet ring cell carcinoma. Both the 5-year overall survival and disease-specific survival rates in signet ring cell carcinoma group were significantly worse than those in non-signet ring cell carcinoma group (41.1 vs. 44.1%, P = 0.012; 43.9 vs. 49.8%, P <0.001). After matching, 1109 pairs were selected, and it was found that neither overall survival nor disease-specific survival was significantly different between the two groups. At multivariate analysis, signet ring cell carcinoma did not influence overall survival (hazard ratio = 1.05, 95% confidence interval 0.93–1.18, P= 0.4661) and disease-specific survival (hazard ratio = 1.01, 95% confidence interval 0.89–1.14, P= 0.907). When patients were stratified by tumor stage, signet ring cell carcinoma was still found to be not associated with decreased survival outcomes in both early and advanced gastric cancer groups. This study demonstrates that signet ring cell carcinoma does not negatively impact survival of gastric cancer patients, regardless of the disease stage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Pernot S, Voron T, Perkins G, Lagorce-Pages C, Berger A, Taieb J (2015) Signet-ring cell carcinoma of the stomach: impact on prognosis and specific therapeutic challenge. World J Gastroenterol 21:11428–11438

    Article  CAS  Google Scholar 

  2. Piessen G, Messager M, Leteurtre E, Jean-Pierre T, Mariette C (2009) Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg 250:878–887

    Article  Google Scholar 

  3. Theuer CP, Nastanski F, Brewster WR, Butler JA, Anton-Culver H (1999) Signet ring cell histology is associated with unique clinical features but does not affect gastric cancer survival. Am Surg 65:915–921

    CAS  PubMed  Google Scholar 

  4. Taghavi S, Jayarajan SN, Davey A, Willis AI (2012) Prognostic significance of signet ring gastric cancer. J Clin Oncol 30:3493–3498

    Article  Google Scholar 

  5. Otsuji E, Yamaguchi T, Sawai K, Takahashi T (1998) Characterization of signet ring cell carcinoma of the stomach. J Surg Oncol 67:216–220

    Article  CAS  Google Scholar 

  6. Rubin DB (1997) Estimating causal effects from large data sets using propensity scores. Ann Intern Med 127:757–763

    Article  CAS  Google Scholar 

  7. D’Agostino RB Jr (1998) Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 17:2265–2281

    Article  Google Scholar 

  8. Postlewait LM, Squires MH 3rd, Kooby DA et al (2015) The prognostic value of signet-ring cell histology in resected gastric adenocarcinoma. Ann Surg Oncol 22(Suppl 3):S832–S839

    Article  Google Scholar 

  9. Kim DY, Park YK, Joo JK, Ryu SY, Kim YJ, Kim SK, Lee JH (2004) Clinicopathological characteristics of signet ring cell carcinoma of the stomach. ANZ J Surg 74:1060–1064

    Article  Google Scholar 

  10. Gronnier C, Messager M, Robb WB, Thiebot T, Louis D, Luc G, Piessen G, Mariette C, FREGAT working group-FRENCH (2013) Is the negative prognostic impact of signet ring cell histology maintained in early gastric adenocarcinoma? Surgery 154:1093–1099

    Article  Google Scholar 

  11. Chon HJ, Hyung WJ, Kim C, Park S, Kim JH, Park CH, Ahn JB, Kim H, Chung HC, Rha SY, Noh SH, Jeung HC (2017) Differential prognostic implications of gastric signet ring cell carcinoma: stage adjusted analysis from a single high-volume center in Asia. Ann Surg 265:946–953

    Article  Google Scholar 

  12. Kao YC, Fang WL, Wang RF, Li AFY, Yang MH, Wu CW, Shyr YM, Huang KH (2019) Clinicopathological differences in signet ring cell adenocarcinoma between early and advanced gastric cancer. Gastric Cancer 22:255–263

    Article  CAS  Google Scholar 

  13. Cunningham D, Allum WH, Stenning SP, Thompson JN, van de Velde CJH, Nicolson M, Scarffe JH, Lofts FJ, Falk SJ, Iveson TJ, Smith DB, Langley RE, Verma M, Weeden S, Chua YJ (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20

    Article  CAS  Google Scholar 

  14. Ychou M, Boige V, Pignon JP, Conroy T, Bouché O, Lebreton G, Ducourtieux M, Bedenne L, Fabre JM, Saint-Aubert B, Genève J, Lasser P, Rougier P (2011) Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol 29:1715–1721

    Article  CAS  Google Scholar 

  15. Messager M, Lefevre JH, Pichot-Delahaye V, Souadka A, Piessen G, Mariette C, Arnaud JP, Balon JM, Bonnetain F, Borie F, Brachet D, Brigand C, Carrere N, D'Journo XB, Dechelotte P, Delpero JR, Dhari A, Fabre S, Fernandez M, Flamein R, Gillet B, Glaise A, Glehen O, Goéré D, Guilbert M, Guiramand J, Hebbar M, Huten N, Kraft K, Leteurtre E, Louis D, Mabrut JY, Mathieu B, Meunier B, Michalak S, Michot F, Millat B, Paye F, Peschaud F, Pezet D, Pocard M, Poisson A, Prudhomme M, Regimbeau JM, Thiébot T, Thomas PA, Tsilividis B, Vandois F (2011) The impact of perioperative chemotherapy on survival in patients with gastric signet ring cell adenocarcinoma: a multicenter comparative study. Ann Surg 254:684–693

    Article  Google Scholar 

  16. Piessen G, Messager M, Le Malicot K et al (2013) Phase II/III multicentre randomised controlled trial evaluating a strategy of primary surgery and adjuvant chemotherapy versus peri-operative chemotherapy for resectable gastric signet ring cell adenocarcinomas - PRODIGE 19 - FFCD1103 - ADCI002. BMC Cancer 13:281

    Article  CAS  Google Scholar 

  17. Ohtsu A, Yoshida S, Saijo N (2006) Disparities in gastric cancer chemotherapy between the East and West. J Clin Oncol 24:2188–2196

    Article  Google Scholar 

  18. Kwon KJ, Shim KN, Song EM, Choi JY, Kim SE, Jung HK, Jung SA (2014) Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the stomach. Gastric Cancer 17:43–53

    Article  Google Scholar 

Download references

Acknowledgements

The authors appreciate the help of Doctor Yanfang Zhao (Department of Health Statistics, Second Military Medical University, Shanghai, China), for her assistance with statistics.

Funding

This research was supported by the Foundation of Fujian Provincial Health Commission (Grant No. 2019-CXB-30).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yanming Zhou.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cai, Z., Wei, Y., Zeng, S. et al. Prognostic Value of Gastric Signet Ring Cell Carcinoma: a Population-Based Propensity Score-Matched Analysis. Indian J Surg 84, 47–54 (2022). https://doi.org/10.1007/s12262-021-02802-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-021-02802-5

Keywords

Navigation