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Prognostic value of signet ring cell histology for survival in stage I and II colon cancer patients: a population-based, propensity score matched analysis

Date

08 Oct 2016

Session

Poster Display

Presenters

Ulrich Gueller

Citation

Annals of Oncology (2016) 27 (6): 149-206. 10.1093/annonc/mdw370

Authors

U. Gueller1, T. Cerny2, B. Schmied3, R. Warschkow3

Author affiliations

  • 1 Dept. Oncology/hematology, Kantonsspital St. Gallen, 9007 - St. Gallen/CH
  • 2 Internal Medicine, Kantonsspital St. Gallen, 9007 - St. Gallen/CH
  • 3 Surgery, Kantonsspital St. Gallen, 9007 - St. Gallen/CH
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Resources

Background

Previous retrospective research associated signet ring cell histology with poor oncologic outcomes in colon cancer patients. However, potential bias can not be ruled out in previous studies. This is the first propensity-score based investigation assessing the prognostic impact of signet ring cell histology on overall and cancer-specific survival in patients with stage I and II colon cancer.

Methods

Stage I and II colon cancer patients undergoing surgery between 2004 and 2013 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) and cancer-specific survival (CSS) were assessed using risk-adjusted Cox proportional hazards regression models and propensity score methods.

Results

Overall, 75,134 stage I-II colon cancer patients were included, of which 380 (0.5%) with signet ring cell histology. In unadjusted analyses, the 5-year OS and CSS in patients with signet ring cell histology was 64.7% (95% confidence interval (CI): 59.3-70.6%) and 84.1% (95% CI: 79.9-88.6%) compared with 73.9% (95% CI: 73.6-74.3%) and 88.6% (95% CI: 88.3-88.9%), respectively, in patients with non-signet ring adenocarcinoma (P = 0.003 and P = 0.026). The survival disadvantage disappeared in risk-adjusted Cox proportional hazard regression analysis (OS: hazard ratio (HR) = 0.96, 95% CI: 0.80-1.15, P = 0.647; CSS 0.88, 95% CI: 0.66-1.17, P = 0.368), and after propensity score matching (OS: HR= 0.92, 95% CI: 0.76-1.11, P = 0.357 and CSS: HR = 0.86, 95% CI: 0.65-1.16, P = 0.315).

Conclusions

This is the first propensity-score adjusted population-based investigation on exclusively stage I and II colon cancer patients providing compelling evidence that signet ring cell histology does not negatively impact survival. Therefore, standard treatment strategies can be applied in these patients.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.

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