Abstract
Little is known regarding the prognostic impact of the signet ring cell (SRC) histotype on negative lymph nodes (LNs) in gastric cancer (GC). In this study, we aimed to investigate the differences between SRC and non-SRC GC patients without LN metastasis. The medical records of patients with GC who underwent gastrectomy at Sun Yat-Sen University Cancer Centre from 1996 to 2012 were reviewed to analyse the clinicopathologic characteristics associated with survival. A total of 480 cases of GC patients without LN metastasis were identified, which included 90 SRC GC patients and 390 non-SRC GC patients. Between the two groups, there were a host of significant differences in the American Joint Committee on Cancer, 7th edition (AJCC) stage. We found that SRC histology was correlated with a poor prognosis in terms of recurrence in node-negative GC patients and that SRC histologic analysis combined with AJCC staging maybe an effectual method for prediction of the recurrence rate. Additionally, we found that SRC GC presents a more dismal overall prognosis in patients with perineural or vascular invasion.
Highlights
Gastric cancer (GC) is the fourth most common malignancy in the world[1]
We examined the effect of signet ring cell (SRC) histology in lymph nodes (LNs)-negative gastric cancer (GC) patients on survival and tumour presentation
Our study first demonstrated that SRC patients have worse recurrence and survival rates, yet SRC histology was not an independent prognostic factor for overall survival in LN-negative GC patients
Summary
The prognostic outcome of GC patients remains ominous, with a 5-year overall survival rate of 25% or less[2]. Nodal metastases represent a known prognostic factor after surgical resection of GC. Patients with negative lymph nodes (LNs) have a good outcome. Approximately 15% of patients with node-negative disease die as a result of postoperative recurrence and metastasis[5,6,7]. The SRC type has been suspected to be a key causative factor of recurrence and metastasis in GC patients. Its prognostic significance in GC patients with negative LNs remains uncertain. The aim of the current study was to evaluate the long-term effect of the SRC type on the prognosis of LN-negative patients
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