Clinicopathological features and outcomes in patients undergoing radical resection for early gastric cancer with signet ring cell histology.
BACKGROUND
The signet ring cell histology is regarded as an independent predictor of poor prognosis in advanced gastric adenocarcinomas, but its biologic behavior in early gastric cancer remains highly controversial.


OBJECTIVE
Our objective was to compare the clinicopathological features and outcomes in patients undergoing curative resection between SRCs and non-SRCs histologic types of early gastric cancer.


METHODS
Clinicopathologic features and the overall survival rates of 334 patients with early gastric cancer undergoing D2 curative resection from January 1994 to December 2008 were retrospectively reviewed and compared according to the histologic type.


RESULTS
Clinicopathologic features were comparable between two groups, except age, ulcer findings and the presence of lymph node metastasis. The incidence of recurrence for SRCs group was significantly lower than that for non-SRCs group (10.4% vs. 19.6%; P<0.05). The overall 5-year survival rate was 88.6% in all cases. The overall survival rate of patients in SRCs group was significantly better than that of patients in non-SRCs group (5-year survival, 93.9% vs. 85.8%; P=0.027). Multivariable analysis revealed that SRCs subtype, lymphovascular invasion, and lymph node metastasis were independent prognostic factors.


CONCLUSIONS
Our analysis revealed that the biological behavior of SRCs was different from other undifferentiated cancer histologic subtypes in early stage. Early gastric cancer with signet ring cell histology had low incidence of lymph node metastasis and a relatively favorable prognosis.
Cancer Hospital of the Chinese Academy of Medical Sciences, Peking Union Medical College, the Department of Abdominal Surgical Oncology, Beijing, China.
Z
Z
Wang
Cancer Hospital of the Chinese Academy of Medical Sciences, Peking Union Medical College, the Department of Abdominal Surgical Oncology, Beijing, China.
X
X
Zhang
Cancer Hospital of the Chinese Academy of Medical Sciences, Peking Union Medical College, the Department of Abdominal Surgical Oncology, Beijing, China.
J
J
Hu
Cancer Hospital of the Chinese Academy of Medical Sciences, Peking Union Medical College, the Department of Abdominal Surgical Oncology, Beijing, China.
W
W
Zeng
Cancer Hospital of the Chinese Academy of Medical Sciences, Peking Union Medical College, the Department of Abdominal Surgical Oncology, Beijing, China. Electronic address: zhouzx2014@gmail.com.
Z
Z
Zhou
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D018279:Carcinoma, Signet Ring Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D055088:Early Detection of Cancer; D005260:Female; D005743:Gastrectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome
Early gastric cancer; Prognosis; Signet ring cell histology