Signet ring cell carcinoma of resectable metastatic colorectal cancer has rare surgical value

J Surg Oncol. 2016 Dec;114(8):1004-1008. doi: 10.1002/jso.24437. Epub 2016 Nov 27.

Abstract

Background and objectives: 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).

Conclusion: 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.

Keywords: SEER; invalid operations; metastatic colorectal cancer (mCRC); signet ring cell carcinoma (SRCC); survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Signet Ring Cell / mortality
  • Carcinoma, Signet Ring Cell / secondary*
  • Carcinoma, Signet Ring Cell / surgery*
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Medical Futility*
  • Middle Aged
  • Neoplasm Metastasis
  • Prognosis
  • Retrospective Studies
  • SEER Program
  • Survival Analysis