Lookup NU author(s): Alexander Phillips,
Professor Michael Griffin
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Background Controversy exists as to the relevance of the signet ring carcinoma (SRC) histological subtype of oesophagogastric adenocarcinoma to long-term prognosis. Some studies report a favourable prognosis while others report the contrary. Methods Retrospective analysis of outcomes of patients who underwent surgery with curative intent in two high volume centres (2000–15). Tumours were analysed according to location (oesophageal, junctional or stomach). Propensity score match (PSM) analysis was used to match patients with signet ring histology to those with oesophagogastric adenocarcinomas based on age, tumour location, use of neoadjuvant and adjuvant chemotherapy and pathological stage. Results A total of 2500 patients with oesophagogastric adenocarcinomas were treated, of whom 198 (7.9%) had signet ring histology. SRCs were more likely to have positive lymph nodes at pathological analysis (59% versus 50%, P = 0.009). Patients with oesophageal SRCs (n = 10) had a particularly poor prognosis with 23% 2 year survival and none alive at 5 years. The five year survival rate for patients with early SRC tumours (Stage 0/I/IIa) was 65% versus 85% for other early cancers (P < 0.003). PSM was used to match 195 of the SRC cases to 573 controls based on stage and treatment. Overall survival was significantly poorer in the SRC group (44.3 ± 8.6 versus 59.8 ± 8.5 months, 5 year OS 41% v 50%, P = 0.027). Conclusion Patients with the SRC variant of oesophagogastric cancer have a poorer prognosis. Genomic studies to identify the composition of such tumours as well as identify strategies to improve treatment for this subtype are warranted.
Author(s): Khan N, Donohoe CL, Phillips AW, Griffin SM, Reynolds JV
Publication type: Conference Proceedings (inc. Abstract)
Publication status: Published
Conference Name: 16th World Congress of the International Society for Diseases of the Esophagus
Year of Conference: 2018
Print publication date: 01/09/2018
Online publication date: 14/09/2018
Acceptance date: 01/05/2018
Publisher: Oxford University Press
Series Title: Diseases of the Esophagus