The value of adjuvant chemotherapy in stage II/III colorectal signet ring cell carcinoma

Zhuang Zhao,Zhi-Wen Li,Na Yan,Dun-Wei Wang,Shu Pan

doi:10.1038/s41598-020-70985-0

Zhuang Zhao, Zhi-Wen Li + Show 3 more

Open Access

https://doi.org/10.1038/s41598-020-70985-0

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Abstract

This study aimed to assess the benefit of postoperative adjuvant chemotherapy in stage II–III colorectal signet ring cell carcinoma (SRCC). Qualified postoperative patients were extracted from Surveillance, Epidemiology, and End Results (SEER) database from 2004 until 2015. We collected 1675 patients in the research, and 936 patients were subjected to adjuvant chemotherapy group. The proportions of married status, male, rectal cancer, grade III/IV, AJCC stage III and radiotherapy were higher; While, the rates of white race, ≥ 65 years old and located in cecum–transverse colon were lower in patients of chemotherapy group compared to no chemotherapy group (all P < 0.05). K-M plots revealed significantly better OS of adjuvant chemotherapy group than no chemotherapy group (P < 0.001). Meanwhile, there was no significantly different in CSS between the two groups (P = 0.93). However, after adjusting for confounding factors by multivariable Cox regression analysis, receipt of postoperative chemotherapy was still associated with better CSS and OS (CSS: hazard ratio [HR] = 0.719, 95% CI 0.612–0.844, P < 0.001) ; (OS: HR = 0.618, 95% CI 0.537–0.713, P < 0.001). Patients with stage II/III colorectal SRCC could receive survival benefit from postoperative adjuvant chemotherapy.

Highlights

Colorectal cancer (CRC) ranks the third of cancer-associated death, causing great health burden g lobally[1]
Hugen et al have assessed the efficacy of adjuvant chemotherapy in colorectal signet ring cell carcinoma (SRCC), who further indicated the benefit of adjuvant chemotherapy in stage III SRCC p atients[11]
1675 eligible patients were included in this research, and 936 patients received adjuvant chemotherapy while 739 patients did not

Summary

Introduction

Colorectal cancer (CRC) ranks the third of cancer-associated death, causing great health burden g lobally[1]. The diverse pathological types of CRC have been uncovered to be having correlation with various clinical parameters and patient survival, with adenocarcinoma being most prevalent t ype[2,3]. Signet-ring cell carcinoma (SRCC) is a relatively rare histological subtype, consisting of 0.1–2.6% of CRC patients[4,5], defined as the abundant presence of intracellular mucin in over 50% cells according to W HO6,7. SRCC is considered as a distinct pathological subtype in CRCs. A series of differences among colorectal SRCC, mucinous adenocarcinoma (MC) and non-mucinous adenocarcinoma (NMC) have been consistently reported. Clear elucidation of the efficacy of postoperative chemotherapy in colorectal SRCC patients is of great significance. In the present study, we collected eligible non-metastatic colorectal SRCC patients from SEER database to investigate the influence of adjuvant chemotherapy

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