title: Signet ring cell carcinoma of resectable metastatic colorectal cancer has rare surgical value.
abstract: OBJECTIVE
  Signet ring cell carcinoma (SRCC) is a uniquely separated subgroup in metastatic colorectal cancer (mCRC). The aims are to investigate the value of resection in patients with resectable metastatic signet ring cell colorectal cancer.
  
  
  METHODS
  Patients with mCRC who underwent resection in Surveillance, Epidemiology, and End Results database during 1998-2010 were retrospectively analyzed. Kaplan-Meier and COX models were used to analyze the differences in the survival. Logistic regression models were used to evaluate the relationship between SRCC and other clinicopathological factors.
  
  
  RESULTS
  Among the 3,568 patients, 94 (2.63%) patients had SRCC. The median survival time of patients with SRCC and non-SRCC were 17 and 29 months, respectively (P < 0.001). Multivariate analysis indicated that SRCC was an independent prognostic factor for poor overall survival. Logistic regression model based on variables identified by univariate analysis indicated that younger age (≤50 years old) (P = 0.005), female (P < 0.001), location in colon (P = 0.012), and N positive status (P = 0.003) were independent variables correlated with the SRCC subgroup. SRCC had a dramatically higher invalid surgical outcome rate than non-SRCC (P = 0.001).
  
  
  CONCLUSIONS
  SRCC patients might benefit little from the resection of primary and metastatic lesions with a high rate of undergoing invalid operations. J. Surg. Oncol. 2016;114:1004-1008. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China.
authors.forename: Jianfei
authors.initials: J
authors.lastname: Fu
authors.affiliation: Department of Gastroenterology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.|Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Lunpo
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Medical Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.|Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education; Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors.forename: Mengjie
authors.initials: M
authors.lastname: Jiang
authors.affiliation: Department of Medical Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.|Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education; Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors.forename: Yinuo
authors.initials: Y
authors.lastname: Tan
authors.affiliation: Department of Medical Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.|Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education; Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.|Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Nuclear Medicine, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Jiang
authors.affiliation: Department of Colorectal Surgery, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China.
authors.forename: Jinlin
authors.initials: J
authors.lastname: Du
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018279:Carcinoma, Signet Ring Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D018447:Medical Futility; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D018426:SEER Program; D016019:Survival Analysis
keywords: SEER; invalid operations; metastatic colorectal cancer (mCRC); signet ring cell carcinoma (SRCC); survival