Lee D, et al. - Gastric signet ring cell carcinoma (SRC) and non-SRC were compared in terms of clinicopathologic features and recurrence patterns in a cohort of Eastern patients. For the first time, the relationship between neural invasion (NI) and peritoneal recurrence was presented as the cause of stage-dependent prognoses for SRC. A better understanding of NI may help to assess cancer spread and recurrence, especially in gastric SRC.

Methods

• The prospectively collected data of 764 patients undergoing curative resection for gastric cancer from 2005 to 2008 was reviewed.
• Analysis of the demographics, clinicopathologic characteristics, disease-specific survival (DSS) rate, and recurrence-free survival (RFS) rate of the patients was performed.

Results

• A relatively worse prognosis was noted for the SRC patients (n=176) than the non-SRC patients (n=588), especially in stages T3 and T4.
• The SRC patients showed significantly increased peritoneal recurrence and incidence of neural invasion (NI), albeit only in stages T3 and T4.
• Researchers noted peritoneal recurrence more frequently in SRC than in non-SRC (28.7% vs 13.7%; p=0.001) in the T3 and T4 patients with NI, but not in the T3 and T4 patients without NI.
• Only in the patients with NI, SRC vs non-SRC, led to a significantly shorter DSS (67.6 vs 90.7 months; p=0.008) and RFS (67.1 vs 80.3 months; p=0.036).