Different prognostic significance of signet ring cell histology for early and advanced gastric cancer patients: a systematic review and meta-analysis. (2nd June 2020)

• Record Type: Journal Article
• Authors: Zhao, Bochao; Lv, Wu; Zhang, Jingting; Zhang, Jiale; Huang, Baojun; Lin, Jie
• Is Part Of: Expert review of gastroenterology & hepatology. Volume 14:Number 6(2020)
• Page Start: 499
• Page End: 509
• Publication Date: 2020-06-02
• Subjects: Gastric cancer -- signet ring cell carcinoma -- histology type -- survival -- prognostic factor; Gastroenterology -- Periodicals; Liver -- Diseases -- Periodicals; 616.3
• DOI: 10.1080/17474124.2020.1769476
• Languages: English
• ISSNs: 1747-4124

Abstract

ABSTRACT: Objective: To review relevant studies and perform a meta-analysis to evaluate the prognostic significance of signet ring cell (SRC) histology for gastric cancer (GC) patients. Methods: Systematic literature search was performed using PubMed and Embase databases. The relevant data were extracted and the association between SRC histology and survival outcome were evaluated using a fixed-effect or random-effect model. Results: A total of 21 studies were included in this meta-analysis. The prevalence of SRC histology varied from 8.7% to 50%. SRC histology type was associated with poorer OS (HR: 1.12, 95%CI: 1.01–1.23, P = 0.034; I 2 = 85.1%) and DFS (HR: 1.17, 95%CI: 1.00–1.37, P = 0.040; I 2 = 63.6%). The subgroup analysis indicated that SRC type had a better OS than non-SRC type for early GC patients (HR: 0.60, 95%CI: 0.48–0.75, P < 0.001; I 2 = 33.7%). However, it was a poor prognostic factor for advanced GC when excluding stage IV patients (HR: 1.18, 95%CI: 1.07–1.29, P < 0.001; I 2 = 6.5%). SRC type had a higher risk of peritoneal recurrence than non-SRC type (OR: 1.36, 95%CI: 1.06–1.75, P = 0.017; I 2 = 1.3%). Conclusion: SRC type had a distinctly different prognostic significance for early and advanced GC patients. SRC type was associated with better survival outcomes in early GC patients, but it was a predictive factor for poor survival in advanced GC patients.