ASPO Abstracts
Clinicopathological Features and Treatments Effects on Gastric Signet-ring Cell Cancer Survival: Results from 2006-2016 SEER Database
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020
Abstract Body:
Purpose: Evidence about prognostic factors of survival for Gastric signet-ring cell carcinoma
(GSRC) is limited. Therefore, we conducted this study to explore the association of
clinicopathological features and treatments with the rare subtype of gastric cancer’s survival by
using the 2006-2016 data from the Surveillance, Epidemiology, and End Results (SEER)
database.
Methods: The SEER database was queried for patients who were diagnosed with GSRC and
mostly accepted surgical resection with or without adjuvant radiochemotherapy (RCT)/
chemotherapy (CT) during 2006-2016. Treatment was re-categorized as none, surgery only, CT
only, surgery+CT, surgery+RCT, others. Log-rank tests were used to demonstrate distribution
differences. Adjusted hazard ratios (HRs) and confidence intervals of overall survival (OS) and
cause-specific survival (CSS) were estimated by using multivariate Cox proportional hazards
models to demonstrate the association, adjusted for age, gender, race, marital status, grade,
stage, tumor site, lymph nodes harvesting, and metastasis. Subgroup analysis was conducted
by tumor site and the AJCC stage. The validation of the nomogram was performed.
Results: A total of 11,627 cases of GSRC were included in the analysis and 5-year OS rate is
22.6%. Approximately half of the participants underwent surgery alone. Compared with tumor
located at cardia and gastroesophageal junction, the HRs (95% CIs) for GSRC death were 0.89
(0.84, 0.95) and 0.92 (0.87, 0.99) for body, antrum and pylorus, respectively. As shown in the
forest plot, those who were male, Asian, married, grade I&II, more lymphoid nodes examined
were associated with a lower risk of GSRC death. We also observed significant declined death
risk of GSRC with surgery alone (aHR=0.34, 95%CI=0.29, 0.39, p-trend<0.01), surgery + CT
(aHR=0.30, 95%CI=0.26, 0.35, p-trend<0.01), surgery + RCT (aHR=0.26 , 95%CI=0.22, 0.30,
p-trend<0.01); however, the elevated effect measure of surgery + RCT appeared to be more
substantial among survivors at an advantage stage (p-interaction<0.01).
Conclusions: This study suggested that GSRC with surgery adjuvant RCT may have a
protective effect on the risk of death. A tailored treatment strategy focusing on different tumor
stage and site is needed to improve survival.
Keywords: Gastric signet-ring cell carcinoma, SEER database, cancer survival