Signet Ring Cell Colorectal and Appendiceal Cancer: A Small Signet Ring Cell Component Is Also Associated with Poor Outcome
Background: Colorectal signet ring cell (SRC) carcinoma with ≥50% SRCs (SRC ≥ 50) has a poor prognosis, but the prognostic role of SRCs < 50% (SRC < 50) is unclear. The aim of this study was to provide a clinicopathological characterization of SRC colorectal and appendiceal tumours and analyse...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/9/2497 |
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| author | Malin Enblad Péter Pál Egerszegi Helgi Birgisson Tobias Sjöblom Bengt Glimelius Joakim Folkesson |
| author_facet | Malin Enblad Péter Pál Egerszegi Helgi Birgisson Tobias Sjöblom Bengt Glimelius Joakim Folkesson |
| author_sort | Malin Enblad |
| collection | DOAJ |
| description | Background: Colorectal signet ring cell (SRC) carcinoma with ≥50% SRCs (SRC ≥ 50) has a poor prognosis, but the prognostic role of SRCs < 50% (SRC < 50) is unclear. The aim of this study was to provide a clinicopathological characterization of SRC colorectal and appendiceal tumours and analyse the importance of the SRC component size. Methods: All patients in the Swedish Colorectal Cancer Registry diagnosed with colorectal or appendiceal cancer in 2009–2020 at Uppsala University Hospital, Sweden, were included. The SRCs were verified, and the components estimated by a gastrointestinal pathologist. Results: Of the 2229 colorectal cancers, 51 (2.3%) had SRCs, with a median component size of 30% (interquartile range of 12.5–40) and 10 (0.45%) had SRC ≥ 50. The SRC tumours were primarily localized in the right colon (59%) and appendix (16%). No patients with SRCs had stage I disease, and 26 (51%) had stage IV, of whom, 18 (69%) had peritoneal metastases. The SRC tumours were often high grade with perineural and vascular invasion. The 5-year overall survival (OS) rate for patients with SRC ≥ 50 were 20% (95% confidence interval (CI) 6–70), for SRC < 50, 39% (95% CI 24–61); and for non-SRCs, 55% (95% CI 55–60). Among the patients with SRC < 50 and <50% extracellular mucin, the 5-year OS was 34% (95% CI 19–61), while those with ≥50% extracellular mucin had an OS of 50% (95% CI 25–99). The 5-year recurrence-free survival rates were 51% (95% CI 13–83) for patients with SRC tumours, as compared to 83% (95% CI 77–89) and 81% (95% CI 79–84) for mucinous and non-mucinous adenocarcinoma, respectively. Conclusions: The presence of SRCs was strongly associated with aggressive clinicopathological features, peritoneal metastases, and poor prognosis, also when they make up <50% of a tumour. |
| first_indexed | 2024-03-11T04:22:42Z |
| format | Article |
| id | doaj.art-e8f181a648784401a5b6464f2d63485f |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T04:22:42Z |
| publishDate | 2023-04-01 |
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| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e8f181a648784401a5b6464f2d63485f2023-11-17T22:40:31ZengMDPI AGCancers2072-66942023-04-01159249710.3390/cancers15092497Signet Ring Cell Colorectal and Appendiceal Cancer: A Small Signet Ring Cell Component Is Also Associated with Poor OutcomeMalin Enblad0Péter Pál Egerszegi1Helgi Birgisson2Tobias Sjöblom3Bengt Glimelius4Joakim Folkesson5Department of Surgical Sciences, Colorectal Surgery, Uppsala University, 751 85 Uppsala, SwedenDepartment of Immunology, Genetics and Pathology, Clinical Pathology, Uppsala University, 751 08 Uppsala, SwedenDepartment of Surgical Sciences, Colorectal Surgery, Uppsala University, 751 85 Uppsala, SwedenDepartment of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, 751 85 Uppsala, SwedenDepartment of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, 751 85 Uppsala, SwedenDepartment of Surgical Sciences, Colorectal Surgery, Uppsala University, 751 85 Uppsala, SwedenBackground: Colorectal signet ring cell (SRC) carcinoma with ≥50% SRCs (SRC ≥ 50) has a poor prognosis, but the prognostic role of SRCs < 50% (SRC < 50) is unclear. The aim of this study was to provide a clinicopathological characterization of SRC colorectal and appendiceal tumours and analyse the importance of the SRC component size. Methods: All patients in the Swedish Colorectal Cancer Registry diagnosed with colorectal or appendiceal cancer in 2009–2020 at Uppsala University Hospital, Sweden, were included. The SRCs were verified, and the components estimated by a gastrointestinal pathologist. Results: Of the 2229 colorectal cancers, 51 (2.3%) had SRCs, with a median component size of 30% (interquartile range of 12.5–40) and 10 (0.45%) had SRC ≥ 50. The SRC tumours were primarily localized in the right colon (59%) and appendix (16%). No patients with SRCs had stage I disease, and 26 (51%) had stage IV, of whom, 18 (69%) had peritoneal metastases. The SRC tumours were often high grade with perineural and vascular invasion. The 5-year overall survival (OS) rate for patients with SRC ≥ 50 were 20% (95% confidence interval (CI) 6–70), for SRC < 50, 39% (95% CI 24–61); and for non-SRCs, 55% (95% CI 55–60). Among the patients with SRC < 50 and <50% extracellular mucin, the 5-year OS was 34% (95% CI 19–61), while those with ≥50% extracellular mucin had an OS of 50% (95% CI 25–99). The 5-year recurrence-free survival rates were 51% (95% CI 13–83) for patients with SRC tumours, as compared to 83% (95% CI 77–89) and 81% (95% CI 79–84) for mucinous and non-mucinous adenocarcinoma, respectively. Conclusions: The presence of SRCs was strongly associated with aggressive clinicopathological features, peritoneal metastases, and poor prognosis, also when they make up <50% of a tumour.https://www.mdpi.com/2072-6694/15/9/2497signet ring cellscolorectal cancerappendiceal cancerperitoneal metastases |
| spellingShingle | Malin Enblad Péter Pál Egerszegi Helgi Birgisson Tobias Sjöblom Bengt Glimelius Joakim Folkesson Signet Ring Cell Colorectal and Appendiceal Cancer: A Small Signet Ring Cell Component Is Also Associated with Poor Outcome Cancers signet ring cells colorectal cancer appendiceal cancer peritoneal metastases |
| title | Signet Ring Cell Colorectal and Appendiceal Cancer: A Small Signet Ring Cell Component Is Also Associated with Poor Outcome |
| title_full | Signet Ring Cell Colorectal and Appendiceal Cancer: A Small Signet Ring Cell Component Is Also Associated with Poor Outcome |
| title_fullStr | Signet Ring Cell Colorectal and Appendiceal Cancer: A Small Signet Ring Cell Component Is Also Associated with Poor Outcome |
| title_full_unstemmed | Signet Ring Cell Colorectal and Appendiceal Cancer: A Small Signet Ring Cell Component Is Also Associated with Poor Outcome |
| title_short | Signet Ring Cell Colorectal and Appendiceal Cancer: A Small Signet Ring Cell Component Is Also Associated with Poor Outcome |
| title_sort | signet ring cell colorectal and appendiceal cancer a small signet ring cell component is also associated with poor outcome |
| topic | signet ring cells colorectal cancer appendiceal cancer peritoneal metastases |
| url | https://www.mdpi.com/2072-6694/15/9/2497 |
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