Early Signet Ring Cell Gastric Cancer

Background Signet ring cell carcinoma (SRC) is defined as a histological entity. The clinicopathological characteristics and prognosis of gastric SRC remain controversial. Methods From 1994 to 2006, 2,439 patients with gastric carcinoma who underwent gastrectomy were enrolled. Of these, 505 patients (20.7%) had SRC and were compared to 1,934 patients with other histological types. Results Twenty-nine percent of patients in the SRC group (n = 149) had early gastric cancer, with tumor invasion limited to the mucosa or submucosa, compared to 22.2% of patients in the non-SRC group (n = 430). The proportion of regional LN metastases was 10.7 and 16.0% in early SRC and early non-SRC, respectively, (p = 0.115). The 5-year survival rates for patients with early SRC were better than those for patients with early non-SRC (96.1 vs. 89.6%, p = 0.01). Conclusions Early gastric SRC has favorable prognosis. There is no significant difference in terms of LN metastasis between SRC histologic type and other histological types. Less-invasive strategies may be acceptable in selected patients with early gastric SRC.