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

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.

[1]  C. Fuchs,et al.  Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial , 2014, The Lancet.

[2]  J. Ajani,et al.  Everolimus for previously treated advanced gastric cancer: results of the randomized, double-blind, phase III GRANITE-1 study. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  A. Davey,et al.  Prognostic significance of signet ring gastric cancer. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  T. Gamblin,et al.  Surgical Treatment of Peritoneal Carcinomatosis from Gastric Cancer , 2012, International journal of surgical oncology.

[5]  M. Shah,et al.  Survival analysis according to disease subtype in AVAGAST: First-line capecitabine and cisplatin plus bevacizumab (bev) or placebo in patients (pts) with advanced gastric cancer. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  C. Mariette,et al.  Is Pretreatment Endoscopic Biopsy a Good Predictor of Signet Ring Cell Histology in Gastric Carcinoma? , 2012, World Journal of Surgery.

[7]  M. Pocard,et al.  The Impact of Perioperative Chemotherapy on Survival in Patients With Gastric Signet Ring Cell Adenocarcinoma: A Multicenter Comparative Study , 2011, Annals of surgery.

[8]  Zhen-ning Wang,et al.  Early gastric cancer with signet-ring cell histologic type: risk factors of lymph node metastasis and indications of endoscopic surgery. , 2011, Surgery.

[9]  C. Mariette,et al.  Signet Ring Cell Histology is an Independent Predictor of Poor Prognosis in Gastric Adenocarcinoma Regardless of Tumoral Clinical Presentation , 2009, Annals of surgery.

[10]  P. Sugarbaker,et al.  Using Pharmacologic Data to Plan Clinical Treatments for Patients with Peritoneal Surface Malignancy , 2009, Current drug discovery technologies.

[11]  T. Sohn,et al.  Indication for endoscopic mucosal resection in early signet ring cell gastric cancer , 2008, Annals of Surgical Oncology.

[12]  S. Choi,et al.  Advanced Gastric Carcinoma with Signet Ring Cell Histology , 2007, Oncology.

[13]  L. Ellis,et al.  Mammalian target of rapamycin is activated in human gastric cancer and serves as a target for therapy in an experimental model , 2007, International journal of cancer.

[14]  S. Al-Batran,et al.  Chemotherapy for advanced gastric cancer. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[15]  C. V. D. van de Velde,et al.  Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. , 2006, The New England journal of medicine.

[16]  Y. J. Kim,et al.  Clinicopathological characteristics of signet ring cell carcinoma of the stomach , 2004, ANZ journal of surgery.

[17]  C. Kunisaki,et al.  Therapeutic strategy for signet ring cell carcinoma of the stomach , 2004, The British journal of surgery.

[18]  Hong Nguyen,et al.  Differential trends in the intestinal and diffuse types of gastric carcinoma in the United States, 1973-2000: increase in the signet ring cell type. , 2004, Archives of pathology & laboratory medicine.

[19]  D. Roder,et al.  The epidemiology of gastric cancer , 2002, Gastric Cancer.

[20]  T. Hickish,et al.  Prospective randomized trial comparing mitomycin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) With epirubicin, cisplatin, and PVI 5-FU in advanced esophagogastric cancer. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[21]  F. Bray,et al.  Cancer burden in the year 2000. The global picture. , 2001, European journal of cancer.

[22]  H. Anton-Culver,et al.  Signet Ring Cell Histology is Associated with Unique Clinical Features but Does Not Affect Gastric Cancer Survival , 1999, The American surgeon.

[23]  T. Saito,et al.  Signet ring cell carcinoma of the stomach: a clinicopathological comparison with the other histological types. , 1998, The Tohoku journal of experimental medicine.

[24]  T. Yamaguchi,et al.  Characterization of signet ring cell carcinoma of the stomach , 1998, Journal of surgical oncology.

[25]  S. Pyrhönen,et al.  Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer. , 1995, British Journal of Cancer.

[26]  H. Yang,et al.  Prognostic significance of signet ring cell carcinoma of the stomach. , 1994, Surgical oncology.

[27]  A. Petroianu,et al.  Modified therapy with 5‐fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer , 1993, Cancer.

[28]  J. Ferlay,et al.  Estimates of the worldwide incidence of eighteen major cancers in 1985 , 1993, International journal of cancer.

[29]  Y. Maehara,et al.  Signet ring cell carcinoma of the stomach , 1992, Cancer.

[30]  A. Cooperman,et al.  Gastric Carcinoma: A Ten‐Year Review , 1983 .

[31]  P. Laurén,et al.  THE TWO HISTOLOGICAL MAIN TYPES OF GASTRIC CARCINOMA: DIFFUSE AND SO-CALLED INTESTINAL-TYPE CARCINOMA. AN ATTEMPT AT A HISTO-CLINICAL CLASSIFICATION. , 1965, Acta pathologica et microbiologica Scandinavica.

[32]  E. Chiorean.  Bevacizumab in Combination With Chemotherapy As First-Line Therapy in Advanced Gastric Cancer: A Randomized, Double-Blind, Placebo-Controlled Phase III Study , 2012 .

[33]  L. Schwartz,et al.  New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). , 2009, European journal of cancer.

[34]  J. Cauvin,et al.  Epidemiology and long term survival of gastric carcinoma in the French district of Finistere between 1984 and 1995. , 2005, Gastroenterologie clinique et biologique.

[35]  D. Parkin.  International variation , 2004, Oncogene.

[36]  W. Hyung,et al.  Early gastric carcinoma with signet ring cell histology , 2002, Cancer.

[37]  D. Arsène,et al.  [Epidemiology and prognosis of gastric carcinomas at the province of Calvados. A 10-year study]. , 1995, Gastroenterologie clinique et biologique.

[38]  J. Pignon,et al.  Efficacy of combined 5-fluorouracil and cisplatinum in advanced gastric carcinomas. A phase II trial with prognostic factor analysis. , 1994, European journal of cancer.

[39]  L. Sobin,et al.  Histological Typing of Oesophageal and Gastric Tumours , 1990, World Health Organization. International Histological Classification of Tumours.