Abstract
IntroductionSignet ring cell carcinoma (SRCC) of the stomach is a histological type based on microscopic characteristics, and its clinicopathologic characteristics and treatment are still controversial. MethodsIn this retrospective study, we reviewed the records of 86 consecutive patients diagnosed with gastric SRCC and treated in the Medical Oncology Department of Hassan II university hospital (Fez, Moroocco) between January 2008 and January 2012. The aim of this study is to identify the epidemiological, clinical and therapeutic features of this type of gastric cancer in a Moroccan population. ResultsIn our study, SRCC of the stomach represent 38 % of the gastric cancer and 11 % of all the digestive tract cancer. The mean age at the diagnosis was 46 years ranged from 25 to 80 years, 64 % were female. The clinical symptoms were mainly vomiting (73 %), epigastric pain (71 %) and deterioration of performance status (94 %). 69 % (n=59) of the patients were metastatic at the diagnosis, sites of metastasis were: peritoneum (85 %), lymphatic nodes (46 %), liver (39 %), lung (32 %), ovaries (10 %), adrenal glands (7 %), bone (5 %) and the kidney (1.6 %). 31 % of the patient had non metastatic disease: localized to the stomach in 19 cases and locally advanced in 8 cases. These patients were treated with curative strategy by total gastrectomy (+/- extended to adjacent organs) followed by adjuvant concomitant chemo radiotherapy (n=9), adjuvant chemotherapy (n=7) or perioperative chemotherapy (n=11). For the metastatic patients, chemotherapy regimens were distributed as following: ECC (Epirubicin 50 mg/m2, Cisplatin 60 mg/m2, Capecitabine 625 mg/m2/12h) was administered to 44 % of the cases; Capecitabine as monotherapy for 17 %, Cisplatine-5FU to 13 % of the cases; FUFOL Mayo clinic regimen for 9 % and EOX (Epirubicin 50 mg/m2, Oxaliplatin 130 mg/m2, Capecitabine 625 mg/m2/12h) for 9 % of the cases. Five metastatic patients were oriented to supportive care given the deterioration of their Performance Status. A second line of chemotherapy was administered to 11 patients based on XELIRI (Irinotecan 250 mg/m2 and Capecitabine 2000mg/d for 14 days) in 5 patients, XELOX (Oxaliplatin 85 mg/m2 and Capecitabine 2000mg/d for 14 days) in 3 patients and FOLFOX4 in the 2 other cases. ConclusionThe gastric Signet ring cell carcinoma represents an entity with specific characteristics, which tends more toward tumor invasion depth, with nodal and peritoneal metastases. Our results are consistent with those of the literature concerning the epidemiological finding and diagnosis aspects. A multidisciplinary approach including cancer surgery and chemotherapy is recommended to improve the prognosis of patients with this disease
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.