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Eur J Surg Oncol. 2014 Dec;40(12):1746-55. doi: 10.1016/j.ejso.2014.04.019. Epub 2014 Jun 26.

Signet ring cell adenocarcinomas: different clinical-pathological characteristics of oesophageal and gastric locations.

Author information

1
Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Centre Hospitalier Régional Universitaire, Lille, France; University of Lille - Nord de France, France; Inserm UMR 837, Jean Pierre Aubert Research Center, Team 5 "Mucins, Epithelial Differentiation and Carcinogenesis", Lille, France. Electronic address: guillaume.piessen@chru-lille.fr.
2
Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Centre Hospitalier Régional Universitaire, Lille, France; University of Lille - Nord de France, France; Inserm UMR 837, Jean Pierre Aubert Research Center, Team 5 "Mucins, Epithelial Differentiation and Carcinogenesis", Lille, France.
3
Department of General and Digestive Surgery, AP-HP, Saint Antoine Hospital, Paris, France.
4
Department of Surgical Oncology, Institut Gustave Roussy, Villejuif Cedex, France.
5
Department of Digestive Surgery and Liver Transplantation, Croix-Rousse University Hospital, Lyon Cedex, France.
6
Department of Hepatobiliary and Digestive Surgery, Pontchaillou University Hospital, Rennes, France.
7
Department of General Surgery, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France.
8
Visceral Department, CHU Angers, France.
9
Surgical Oncology Department, Centre Hospitalo-Universitaire Lyon Sud, Pierre Bénite, France.

Abstract

AIMS:

The incidence of oesogastric (OG) signet ring cell adenocarcinoma (SRC) is increasing in Western countries. The differential characteristics between oesophageal and gastric SRC tumours are unknown. We aimed to investigate the role of tumour location on prognosis in OG SRC.

METHODS:

Among 924 OG SRC resected in 21 centres from 1997 to 2010, consecutive patients who had oesophageal tumours (group OESO, n = 136) were matched to randomly selected patients who had gastric tumours (group GASTRIC, n = 363). Matching variables were gender, age, American Society of Anaesthesiologists score, malnutrition, pretherapeutic clinical TNM stage and neoadjuvant treatment. Patients and tumour characteristics were compared between groups and prognostic factors were identified.

RESULTS:

The two groups were well matched. Tumours in group GASTRIC were more advanced at surgical exploration, with higher rates of linitis plastica (P < 0.001), peritoneal carcinomatosis (P = 0.001), and advanced pTNM stages (P = 0.034). Radicality of resection and recurrence rates were similar (P > 0.480). Recurrences were more frequently distant (P < 0.001) and peritoneal (P < 0.001) in group GASTRIC. After adjustment on confounding variables, gastric location (P = 0.034) was independently associated with a better prognosis than oesophageal location.

CONCLUSION:

Gastric and oesophageal SRC tumours are distinct diseases. Despite similar pretherapeutic factors, gastric tumours were more advanced with a greater propensity for the peritoneal surface at the diagnosis and recurrence and associated with a better prognosis.

KEYWORDS:

Cancer; Case control study; Gastric; Oesophagus; Prognosis; Signet ring cell

PMID:
25012732
DOI:
10.1016/j.ejso.2014.04.019
[Indexed for MEDLINE]

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