title: Outcomes of surgical treatment of primary signet ring cell carcinoma of the colon and rectum: 22 cases reviewed with literature.
abstract: Colorectal primary signet ring cell carcinoma (PSRCCR) is a rare entity with a dismal prognosis, mainly because of delayed diagnosis. The objective of this study was to investigate the clinicopathologic features and prognostic factors for PSRCCR. This is a retrospective study including the data of 22 patients with PSRCCR who underwent surgery. Patients were categorized by age, sex, tumor site, and stage. Fifteen patients were male. Median age was 40 years. Sites for metastases were lymph nodes (86.4%), peritoneum (40.9%), and liver (9.1%). Most of the patients (91%) had stage III or IV tumors. The rates of curative and palliative resections performed were equal. Mean overall survival and mean progression-free survival times were found to be 33.3 ± 7.1 months (95% confidence interval, 19.4-47.2 months) and 11.8 ± 3.5 months (95% confidence interval, 4.9-18.7 months), respectively. It was concluded that site of the tumor, presence of bowel obstruction, peritoneum and lung metastases, adjacent organ infiltration, TNM stage, and efficiency of surgery have significant effects on survival. All in all, these aggressive tumors are generally diagnosed at advanced stages. Depending on the situation, survival is shorter. A high degree of vigilance is required for these patients to avoid the negative impact of late diagnosis on survival.
authors.affiliation: 1 Department of Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Belli
authors.forename: Huseyin Ozgur
authors.initials: HO
authors.lastname: Aytac
authors.forename: Erdal
authors.initials: E
authors.lastname: Karagulle
authors.forename: Hakan
authors.initials: H
authors.lastname: Yabanoglu
authors.forename: Fazilet
authors.initials: F
authors.lastname: Kayaselcuk
authors.forename: Sedat
authors.initials: S
authors.lastname: Yildirim
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000556:secondary; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Colorectal cancer; Histopathology; Signet ring cell; Survival