title: Signet ring cell adenocarcinomas: different clinical-pathological characteristics of oesophageal and gastric locations.
abstract: OBJECTIVE
  The incidence of oesogastric (OG) signet ring cell adenocarcinoma (SRC) is increasing in Western countries. The differential characteristics between oesophageal and gastric SRC tumours are unknown. We aimed to investigate the role of tumour location on prognosis in OG SRC.
  
  
  METHODS
  Among 924 OG SRC resected in 21 centres from 1997 to 2010, consecutive patients who had oesophageal tumours (group OESO, n = 136) were matched to randomly selected patients who had gastric tumours (group GASTRIC, n = 363). Matching variables were gender, age, American Society of Anaesthesiologists score, malnutrition, pretherapeutic clinical TNM stage and neoadjuvant treatment. Patients and tumour characteristics were compared between groups and prognostic factors were identified.
  
  
  RESULTS
  The two groups were well matched. Tumours in group GASTRIC were more advanced at surgical exploration, with higher rates of linitis plastica (P < 0.001), peritoneal carcinomatosis (P = 0.001), and advanced pTNM stages (P = 0.034). Radicality of resection and recurrence rates were similar (P > 0.480). Recurrences were more frequently distant (P < 0.001) and peritoneal (P < 0.001) in group GASTRIC. After adjustment on confounding variables, gastric location (P = 0.034) was independently associated with a better prognosis than oesophageal location.
  
  
  CONCLUSIONS
  Gastric and oesophageal SRC tumours are distinct diseases. Despite similar pretherapeutic factors, gastric tumours were more advanced with a greater propensity for the peritoneal surface at the diagnosis and recurrence and associated with a better prognosis.
authors.affiliation: Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Centre Hospitalier Régional Universitaire, Lille, France; University of Lille - Nord de France, France; Inserm UMR 837, Jean Pierre Aubert Research Center, Team 5 "Mucins, Epithelial Differentiation and Carcinogenesis", Lille, France. Electronic address: guillaume.piessen@chru-lille.fr.
authors.forename: G
authors.initials: G
authors.lastname: Piessen
authors.affiliation: Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Centre Hospitalier Régional Universitaire, Lille, France; University of Lille - Nord de France, France; Inserm UMR 837, Jean Pierre Aubert Research Center, Team 5 "Mucins, Epithelial Differentiation and Carcinogenesis", Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Messager
authors.affiliation: Department of General and Digestive Surgery, AP-HP, Saint Antoine Hospital, Paris, France.
authors.forename: J H
authors.initials: JH
authors.lastname: Lefevre
authors.affiliation: Department of Surgical Oncology, Institut Gustave Roussy, Villejuif Cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Goéré
authors.affiliation: Department of Digestive Surgery and Liver Transplantation, Croix-Rousse University Hospital, Lyon Cedex, France.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Mabrut
authors.affiliation: Department of Hepatobiliary and Digestive Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: B
authors.initials: B
authors.lastname: Meunier
authors.affiliation: Department of General Surgery, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France.
authors.forename: C
authors.initials: C
authors.lastname: Brigand
authors.affiliation: Visceral Department, CHU Angers, France.
authors.forename: A
authors.initials: A
authors.lastname: Hamy
authors.affiliation: Surgical Oncology Department, Centre Hospitalo-Universitaire Lyon Sud, Pierre Bénite, France.
authors.forename: O
authors.initials: O
authors.lastname: Glehen
authors.affiliation: Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Centre Hospitalier Régional Universitaire, Lille, France; University of Lille - Nord de France, France; Inserm UMR 837, Jean Pierre Aubert Research Center, Team 5 "Mucins, Epithelial Differentiation and Carcinogenesis", Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Mariette
mesh_terms: D000328:Adult; D000368:Aged; D018279:Carcinoma, Signet Ring Cell / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*
keywords: Cancer; Case control study; Gastric; Oesophagus; Prognosis; Signet ring cell