title: Signet ring cell carcinoma of the stomach is significantly associated with poor prognosis and diffuse gastric cancer (Lauren's): single-center experience of 160 cases.
abstract: OBJECTIVE
  The aim of this study was to evaluate survival rates and treatment response in stage I-IV gastric cancer in relation to tumor stage (TNM), histology, Lauren's classification and tumor localization.
  
  
  METHODS
  Clinical and histopathological data of 160 patients with stage I-IV gastric cancer were analyzed in this retrospective, single-center study.
  
  
  RESULTS
  Most patients (73.1%) showed an advanced or metastatic tumor stage (III/IV). The median 3-year overall survival (OS) was 20 ± 16.8 months and correlated significantly with tumor stage (I: OS 30.6 ± 15 months vs. IV: 10.4 ± 9.3 months; p < 0.0001). Stage III/IV tumors were significantly more often poorly differentiated (G3; p = 0.011) and located in the corpus region. Signet ring cell (SRC) cancers were found in a larger proportion of these tumors when compared with locally limited gastric cancers (43.1% vs. 16.3%; p = 0.002). SRC tumors occurred predominantly in women and younger patients and histology was significantly more often of the diffuse subtype according to Lauren (7.5% vs. 63.2%; p < 0.0001) and poorly differentiated (G3 in 95% vs. 73%; p = 0.001).
  
  
  CONCLUSIONS
  SRC gastric cancer correlates with poor histopathological criteria and poor prognosis when compared with other histological subtypes. These observations underline the need for more effective treatment in addition to standard approaches.
authors.affiliation: Department of Internal Oncology and Rehabilitation, Paracelsus Hospital Scheidegg, Germany.
authors.forename: Holger G
authors.initials: HG
authors.lastname: Hass
authors.forename: Ute
authors.initials: U
authors.lastname: Smith
authors.forename: Christina
authors.initials: C
authors.lastname: Jäger
authors.forename: Michael
authors.initials: M
authors.lastname: Schäffer
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wellhäuber
authors.forename: Thomas
authors.initials: T
authors.lastname: Hehr
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Markmann
authors.forename: Oliver
authors.initials: O
authors.lastname: Nehls
authors.forename: Claudio
authors.initials: C
authors.lastname: Denzlinger
mesh_terms: D000368:Aged; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D016019:Survival Analysis; D015996:Survival Rate