Fu Jianfei, Wu Lunpo, Jiang Mengjie, Tan Yinuo, Li Dan, Chen Fei, Jiang Ting, Du Jinlin
Department of Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China.
Department of Gastroenterology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
J Surg Oncol. 2016 Dec;114(8):1004-1008. doi: 10.1002/jso.24437. Epub 2016 Nov 27.
Signet ring cell carcinoma (SRCC) is a uniquely separated subgroup in metastatic colorectal cancer (mCRC). The aims are to investigate the value of resection in patients with resectable metastatic signet ring cell colorectal cancer.
Patients with mCRC who underwent resection in Surveillance, Epidemiology, and End Results database during 1998-2010 were retrospectively analyzed. Kaplan-Meier and COX models were used to analyze the differences in the survival. Logistic regression models were used to evaluate the relationship between SRCC and other clinicopathological factors.
Among the 3,568 patients, 94 (2.63%) patients had SRCC. The median survival time of patients with SRCC and non-SRCC were 17 and 29 months, respectively (P < 0.001). Multivariate analysis indicated that SRCC was an independent prognostic factor for poor overall survival. Logistic regression model based on variables identified by univariate analysis indicated that younger age (≤50 years old) (P = 0.005), female (P < 0.001), location in colon (P = 0.012), and N positive status (P = 0.003) were independent variables correlated with the SRCC subgroup. SRCC had a dramatically higher invalid surgical outcome rate than non-SRCC (P = 0.001).
SRCC patients might benefit little from the resection of primary and metastatic lesions with a high rate of undergoing invalid operations. J. Surg. Oncol. 2016;114:1004-1008. © 2016 Wiley Periodicals, Inc.
印戒细胞癌(SRCC)是转移性结直肠癌(mCRC)中一个独特的亚组。目的是探讨可切除的转移性结直肠印戒细胞癌患者行手术切除的价值。
对1998 - 2010年监测、流行病学和最终结果数据库中接受手术切除的mCRC患者进行回顾性分析。采用Kaplan-Meier法和COX模型分析生存差异。采用逻辑回归模型评估SRCC与其他临床病理因素之间的关系。
在3568例患者中,94例(2.63%)为SRCC。SRCC患者和非SRCC患者的中位生存时间分别为17个月和29个月(P < 0.001)。多因素分析表明,SRCC是总体生存不良的独立预后因素。基于单因素分析确定的变量建立的逻辑回归模型表明,年龄较小(≤50岁)(P = 0.005)、女性(P < 0.001)、肿瘤位于结肠(P = 0.012)和N阳性状态(P = 0.003)是与SRCC亚组相关的独立变量。SRCC的无效手术结局发生率显著高于非SRCC(P = 0.001)。
SRCC患者行原发灶和转移灶切除可能获益甚微,无效手术发生率高。《外科肿瘤学杂志》2016年;114:1004 - 1008。© 2016威利期刊公司