Signet Ring Cells and Efficacy of First-line Chemotherapy in Advanced Gastric or Oesogastric Junction Adenocarcinoma

Abstract

Aim: To evaluate the efficacy of first-line palliative chemotherapy, regarding the presence of signet ring cells (SRC).

Patients and methods: Retrospective analysis of consecutive patients with locally advanced or metastatic gastric or oesogastric junction adenocarcinoma who received first-line chemotherapy. Response to chemotherapy, progression-free survival (PFS) and overall survival (OS) were compared between SRC and non-SRC (NSRC) groups.

Results: Two hundred and three patients were treated, with 57 (28%) having SRC adenocarcinoma. Objective response rate was significantly lower in SRC patients (5.3% vs. 28.1%, p=0.0004). PFS was not significantly different between SRC and NSRC patients (median=3.8 vs. 4.9 months, p=0.07). OS was significantly shorter in SRC patients (median=5.6 vs. 9.4 months, p<0.008). In multivariate analysis SRC was not an independent prognostic factor for OS (hazard ratio (HR)=1.28, p=0.15).

Conclusion: Patients with advanced SRC adenocarcinomas seemed to benefit less from chemotherapy, whereas the presence of SRC was not an independent survival prognostic factor.

Keywords: Signet ring cells; gastric adenocarcinoma; oesogastric junction adenocarcinoma; prognosis.