Intest Res.  2015 Oct;13(4):332-338. 10.5217/ir.2015.13.4.332.

Clinical Features and Prognosis of Resectable Primary Colorectal Signet-Ring Cell Carcinoma

• Lee HS
• Soh JS
• Lee S
• Bae JH
• Kim KJ
• Ye BD
• Byeon JS
• Myung SJ
• Yang SK
• Kim SA
• Park YS
• Lim SB
• Kim JC
• Yu CS
• Yang DH

• KMID: 2070749
• DOI: http://doi.org/10.5217/ir.2015.13.4.332

Abstract

BACKGROUND/AIMS
We attempted to investigate the prognosis of signet-ring cell carcinoma (SRC) patients who underwent curative surgery by comparing them with age-, sex-, and stage-matched non-mucinous adenocarcinoma (NMAC) patients.
METHODS
Between January 2003 and December 2011, 19 patients with primary SRC of the colorectum underwent curative surgery. Four SRC patients under the age of 40 were excluded, and the clinicopathological data of 15 patients (7 men; median age, 56 years) were reviewed and compared with the data of 75 NMAC patients matched by age, sex, and pathologic stage.
RESULTS
The median follow-up duration was 30.1 months for the SRC group and 43.7 months for the NMAC group (P=0.141). Involvement of the left side of the colon (73.3% vs. 26.7%, P=0.003) and infiltrative lesions such as Borrmann types 3 and 4 (85.7% vs. 24.0%, P=0.001) were more common in the SRC group than in the NMAC group. The five-year overall survival rate was significantly lower for patients with SRC than for those with NMAC (46.0% vs. 88.7%, hazard ratio, 6.99; 95% confidence interval, 2.33-20.95, P=0.001).
CONCLUSIONS
Patients with even resectable primary colorectal SRC had a poorer prognosis than age-, sex-, and stage-matched colorectal NMAC patients.

Keyword

Colorectal neoplasms; Adenocarcinoma; Carcinoma, signet-ring cell; General surgery; Survival

MeSH Terms

Adenocarcinoma
Colon
Colorectal Neoplasms
Follow-Up Studies
Humans
Male
Prognosis*
Survival Rate

Figure

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  Fig. 1 Borrmann classification of colorectal cancer. (A) A case of Bormann type I (polypoid type) non-mucinous adenocarcinoma; (B) A case of Bormann type II (ulcerofungating type) signet-ring cell carcinoma (SRC); (C) A case of Bormann type III (ulceroinfiltrative type) SRC; and (D) A case of Bormann type IV (infiltrative type) SRC.

• 

  Fig. 2 Kaplan-Meier survival curves comparing the recurrence-free (A) and overall survival (B) of patients with signet-ring-cell carcinoma (SRC) and patients with non-mucinous adenocarcinoma (NMAC) (log-rank test).

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