Tamhankar Anup Sunil, Ingle Parag, Engineer Reena, Bal Munita, Ostwal Vikas, Saklani Avanish
Anup Sunil Tamhankar, Parag Ingle, Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra 400012, India.
World J Gastrointest Oncol. 2016 Dec 15;8(12):819-825. doi: 10.4251/wjgo.v8.i12.819.
To elaborate about this peculiar variant from a tertiary cancer center from India.
It's a retrospective study (2011-2014) of all patients diagnosed with signet ring colo-rectal cancer (SRCC). Various clinico-pathological variables were studied.
One hundred and seventy consecutive patients with SRCC were diagnosed (11.4% of all colorectal cancers). Median Age of the cohort was 41 years. Most common location was recto-sigmoid area (54.7%). Majority patients presented in stage III and IV (91.2%). Most of the stage IV patients had isolated peritoneal metastases (86.5%). Colonic tumors had higher incidence of peritoneal metastases (91.8% 83.3%) as well as isolated peritoneal recurrences (37.5% 16.7%) than rectal primaries. Thirty-seven point five percent of patients recurred after curative surgery. Amongst them 63.63% patients had isolated peritoneal recurrences. Circumferential resection margin (CRM) was involved in 17.9% patients. Median relapse free survival (RFS) and overall survival (OS) of the cohort were 14.9 and 18.13 mo respectively. CRM involvement, colonic primary were associated with poorer RFS and OS.
SRCC has predilection for peritoneal dissemination. More aggressive and/or extended chemotherapy schedules as well as prophylactic hyperthermic intra-peritoneal chemotherapy at the time of primary surgery may be attempted in these patients.
阐述来自印度一家三级癌症中心的这种特殊变体。
这是一项对所有诊断为印戒细胞型结直肠癌（SRCC）患者的回顾性研究（2011 - 2014年）。研究了各种临床病理变量。
连续诊断出170例SRCC患者（占所有结直肠癌的11.4%）。该队列的中位年龄为41岁。最常见的部位是直肠乙状结肠区域（54.7%）。大多数患者表现为Ⅲ期和Ⅳ期（91.2%）。大多数Ⅳ期患者有孤立性腹膜转移（86.5%）。与直肠原发性肿瘤相比，结肠肿瘤的腹膜转移发生率（91.8%对83.3%）以及孤立性腹膜复发率（37.5%对16.7%）更高。37.5%的患者在根治性手术后复发。其中63.63%的患者有孤立性腹膜复发。17.9%的患者环周切缘（CRM）受累。该队列的中位无复发生存期（RFS）和总生存期（OS）分别为14.9个月和18.13个月。CRM受累、结肠原发性肿瘤与较差的RFS和OS相关。
SRCC倾向于腹膜播散。对于这些患者，可尝试更积极和/或延长的化疗方案以及在初次手术时进行预防性腹腔内热化疗。
