title: Signet ring cell histology is not an independent predictor of poor prognosis after curative resection for gastric cancer: a propensity analysis by the KLASS Group.
abstract: Whether signet ring cell (SRC) histology carries a worse prognosis than other forms of gastric adenocarcinoma has been questioned. The present study investigated the differences in clinicopathologic features and survival between SRC and non-SRC adenocarcinoma. The prospectively collected data of 2643 patients who had undergone curative gastrectomy between 1998 and 2005 by 10 surgeons were reviewed. Additionally, we employed analysis of covariance, propensity-score risk adjustment, and propensity-based matching to account for possible selection bias. The baseline characteristics of prematched patients with SRC or non-SRC adenocarcinoma histology differed: SRC presented in younger patients and less often in men, was more likely found in the middle stomach, and was more likely to be Stage I. After applying the propensity-score strata and propensity-score matching, there was no difference in the baseline characteristics, and SRC was not an independent risk factor for mortality in the same stage. SRC is not an independent predictor of poor prognosis after curative resection for gastric cancer in Korea.
authors.affiliation: From the Department of Surgery (JHS, KYS, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul; Department of Surgery (H-HK), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea; Department of Surgery (S-UH), Ajou University School of Medicine, Suwon; Department of Surgery (M-CK), Dong-A University College of Medicine, Busan; Department of Surgery (WJH), Institute of Gastroenterology, Yonsei University College of Medicine; Department of Surgery (WK), Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Department of Surgery (H-JL), Cancer Research Institute, Seoul National University College of Medicine, Seoul; Department of Surgery (SWR), Keimyung University School of Medicine, Daegu; Department of Surgery (GSC), Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon; and Department of Surgery (SYR), Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Shim
authors.forename: Kyo Young
authors.initials: KY
authors.lastname: Song
authors.forename: Hyung-Ho
authors.initials: HH
authors.lastname: Kim
authors.forename: Sang-Uk
authors.initials: SU
authors.lastname: Han
authors.forename: Min-Chan
authors.initials: MC
authors.lastname: Kim
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
authors.forename: Wook
authors.initials: W
authors.lastname: Kim
authors.forename: Hyuk-Joon
authors.initials: HJ
authors.lastname: Lee
authors.forename: Seung Wan
authors.initials: SW
authors.lastname: Ryu
authors.forename: Gyu Seok
authors.initials: GS
authors.lastname: Cho
authors.forename: Seong Yeob
authors.initials: SY
authors.lastname: Ryu
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018279:Carcinoma, Signet Ring Cell / Q000401:mortality / Q000473:pathology; D057216:Propensity Score; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology