Clinical Correlates and Prognostic Value of Different Metastatic Sites in Gastric and Colorectal Signet Ring Cell Carcinoma

Gastric signet ring cell carcinoma (SRCC) and colorectal SRCC are the most aggressive histological types of carcinoma related to a poor prognosis, and place a heavy burden on public health. We undertook a population-based study to analyze the metastatic patterns of SRCC and further estimate its contribution to the cancer-specific survival of gastric SRCC and colorectal SRCC. Data from eligible patients diagnosed with gastric or colorectal SRCC between 2010 and 2012 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Chi-squared tests were used to clarify the clinical features in patients with metastatic disease compared with those without metastatic disease. Survival differences of patients with different metastatic sites were compared with a Kaplan-Meier analysis, and other prognostic factors were examined by Cox proportional hazards models. A total of 4055 patients with gastric SRCC or colorectal SRCC were included in our cohort. Among them, 2905 were diagnosed with gastric SRCC, and the remaining 1150 patients were diagnosed with colorectal SRCC. In gastric SRCC, distant lymph nodes were the most common metastatic sites. Furthermore, patients with brain metastases had the worst prognosis. In colorectal SRCC, the liver was the most common metastatic site, and patients with distant lymph node metastases had the highest mortality. In summary, metastasis is a major contributor to cancer mortality in SRCC. The results from our study provide some information for developing follow-up strategies in future studies. (C) 2020 THE AUTHORS. Published by Elsevier LTD on behalf of Chinese Academy of Engineering and Higher Education Press Limited Company.