J Korean Surg Soc.
2000 Dec;59(6):771-777.
The Clinicopathologic Characteristics and Prognosis of Gastric Signet Ring Cell Carcinoma
- Affiliations
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- 1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Abstract
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PURPOSE: There has been considerable controversy over the prognosis of gastric signet ring cell
carcinoma (SRC). To clarify the biologic behavior of SRC, we evaluated the clinicopathologic features
and the prognosis of SRC. METHODS: A total of 3,104 patients with a gastric carcinoma who had
undergone a gastrectomy from 1987 to 1995 were analyzed retrospectively. Among them, 556 patients
with SRC were compared to 2,548 patients with non-SRC. RESULTS: Patients with SRC were younger
than those with non-SRC, and female were prevalent. Incidence of EGC were higher in patients with
SRC. EGC with SRC had a larger proportion of mucosa-confined lesions and a lower rate of lymph
node metastasis than EGC with non-SRC. Multivariate analysis showed that SRC was a negative inde
pendent risk factor for lymph node metastasis. Among advanced gastric cancers SRCs showed a higher
prevalence of large-sized lesions, Borrmann type IV lesions, and advanced nodal stage, as well as a
higher rate of peritoneal metastasis. The 5-year survival rate of EGC with SRC (93.8%) was higher than
that of non-SRC (91.2%). However, the prognosis of advanced SRC (49.0%) was poorer than that of
non-SRC (53.5%). CONCLUSION: A female preponderance, a younger age, and a higher proportion of early
gastric cancer characterized the peculiar biologic behavior of gastric signet ring cell carcinoma. In addi
tion, the prognosis of SRC was poor once invasion had gone beyond the submucosa. These findings
suggest that signet ring cell carcinoma of the stomach should be regarded as a distinct type of gastric cancer.