ASPO Abstracts

Authors: Li Y; Zhu ZK; Tian YT

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

Return to Abstract Listing