Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr;8(4):1930-1940.
doi: 10.1002/cam4.2054. Epub 2019 Mar 12.

Chemotherapy is associated with increased survival from colorectal signet ring cell carcinoma with distant metastasis: A Surveillance, Epidemiology, and End Results database analysis

Tao Shi  1 , Mengxi Huang  1 , Dong Han  2 , Xinyi Tang  1 , Yanyan Chen  1 , Zhiping Li  2 , Chao Liu  3 , Dan Xiang  1 , Ting Wang  1 , Yitian Chen  1 , Rui Wang  1 , Zengjie Lei  1   2 , Xiaoyuan Chu  1   2
Affiliations

Chemotherapy is associated with increased survival from colorectal signet ring cell carcinoma with distant metastasis: A Surveillance, Epidemiology, and End Results database analysis

Tao Shi et al. Cancer Med. 2019 Apr.

Abstract

Background: Colorectal signet ring cell carcinoma (SRCC) is a rare histological subtype of colorectal adenocarcinoma with high metastatic frequency compared to non-SRCC colorectal cancer (NOS). The aim of this study was to analyze prognostic factors of colorectal SRCC with different metastatic sites and evaluate impacts of various therapies for metastatic colorectal SRCC.

Methods: Patients with NOS and SRCC were from the Surveillance, Epidemiology, and End Results (SEER) database during 2010-2014. χ2 tests were used to compare data significance. Kaplan-Meier and COX models were used to analyze the differences in the survival. Propensity-matched analyses were used to adjust numerical differences.

Results: Among the 173 460 patients, 1932 (1.11%) patients had colorectal SRCC. In univariate analysis, older age, male sex, and peritoneum metastasis were associated with higher mortality risk. The peritoneum was both the site with the highest metastatic frequency and the site with the worst prognosis in SRCC. In the COX regression model, peritoneum-metastatic SRCC patients receiving chemotherapy had better survival than patients treated with surgery.

Conclusions: Our study analyzed the unique metastatic pattern of colorectal SRCC toward different sites and found that compared to surgery, chemotherapy was associated with better survival for colorectal SRCC patients with distant metastasis, which provided insights for future SRCC patient treatment.

Keywords: SEER database; chemotherapy; peritoneum metastasis; signet ring cell carcinoma; surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart for creation of the Surveillance, Epidemiology, and End Results (SEER) patient dataset
Figure 2
Figure 2
A, Overall survival among NOS and SRCC patients with and without metastasis. P < 0.001. B, Cause‐specific survival among NOS and SRCC patients with and without metastasis. P < 0.001. C, Overall survival among NOS and SRCC patients with and without metastasis after PSM P < 0.001. D, Cause‐specific survival among NOS and SRCC patients with and without metastasis after PSM P < 0.001. NOS, non‐SRCC colorectal cancer; SRCC, colorectal signet ring cell carcinoma; PSM, propensity score matching
Figure 3
Figure 3
A, Overall survival among SRCC patients with distant metastatic sites (multiple, liver, peritoneum, distant lymph node, and nonmetastatic); P < 0.001. B, Cause‐specific survival among SRCC patients with distant metastatic sites (multiple, liver, peritoneum, distant lymph node, and nonmetastatic); P < 0.001. SRCC, colorectal signet ring cell carcinoma
Figure 4
Figure 4
A, Subgroup analysis of surgery effect among SRCC patients with distant metastatic sites (multiple, liver, peritoneum, distant lymph node, and nonmetastatic); P < 0.001. B, Subgroup analysis of chemotherapy effect among SRCC patients with distant metastatic sites (multiple, liver, peritoneum, distant lymph node, and nonmetastatic); P < 0.001. C, Subgroup analysis of radiotherapy effect among SRCC patients with distant metastatic sites (multiple, liver, peritoneum, distant lymph node, and nonmetastatic); P > 0.001. SRCC, colorectal signet ring cell carcinoma; CI, confidence interval
See this image and copyright information in PMC

References

    1. El‐Shami K, Oeffinger KC, Erb NL, et al. American cancer society colorectal cancer survivorship care guidelines. CA Cancer J Clin. 2015;65:428‐455. 10.3322/caac.21286. - DOI - PMC - PubMed
    1. Laufman H, Saphir O. Primary linitis plastica type of carcinoma of the colon. AMA Arch Surg. 1951;62:79‐91. - PubMed
    1. Gopalan V, Smith RA, Ho YH, Lam AK. Signet‐ring cell carcinoma of colorectum–current perspectives and molecular biology. Int J Colorectal Dis. 2011;26:127‐133. 10.1007/s00384-010-1037-z. - DOI - PubMed
    1. Hugen N, van de Velde CJ, de Wilt JH, Nagtegaal ID. Metastatic pattern in colorectal cancer is strongly influenced by histological subtype. Ann Oncol. 2014;25:651‐657. 10.1093/annonc/mdt591. - DOI - PMC - PubMed
    1. Hugen N, Verhoeven RH, Lemmens VE, et al. Colorectal signet‐ring cell carcinoma: benefit from adjuvant chemotherapy but a poor prognostic factor. Int J Cancer. 2015;136:333‐339. 10.1002/ijc.28981. - DOI - PubMed

Publication types

MeSH terms

Substances