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Signet ring cells in esophageal adenocarcinoma predict poor response to preoperative chemoradiation.
[esophageal adenocarcinoma]
The
purpose
of
this
study
was
to
examine
the
significance
of
signet
ring
cell
histology
to
predict
response
to
preoperative
chemoradiotherapy
in
patients
with
esophageal
adenocarcinoma
.
Two
groups
of
patients
with
locoregional
esophageal
adenocarcinoma
treated
with
neoadjuvant
chemoradiation
and
surgery
were
studied
:
those
with
signet
ring
cell
adenocarcinoma
(
n
=
85
)
and
a
reference
group
(
n
=
638
)
with
usual
and
other
types
of
adenocarcinoma
.
Surgical
specimens
were
reviewed
for
degree
of
pathologic
response
and
pathologic
stage
.
Cox
regression
models
were
used
to
assess
the
effects
of
clinicopathologic
variables
on
survival
.
Tumors
from
patients
in
the
signet
ring
cell
group
had
a
lower
rate
of
complete
pathologic
response
(
9
%
versus
26
%
,
p
<
0
.
001
)
and
more
frequent
positive
margins
(
24
%
versus
10
%
,
p
<
0
.
001
)
compared
with
tumors
from
the
reference
group
.
Median
overall
survival
(
22
versus
48
months
,
p
=
0
.
003
)
and
disease-free
survival
(
16
versus
35
months
,
p
=
0
.
007
)
were
shorter
in
the
signet
ring
cell
group
than
in
the
reference
group
.
Signet
ring
cell
histology
and
high
pathologic
stage
were
significant
predictors
of
decreased
overall
survival
and
disease-free
survival
.
Survival
durations
for
patients
whose
resected
specimens
showed
downstaging
after
neoadjuvant
chemoradiation
did
not
significantly
differ
from
survival
durations
of
patients
whose
specimens
did
not
show
downstaging
in
the
signet
ring
cell
group
,
unlike
the
reference
group
.
Signet
ring
cell
histology
on
pretreatment
biopsy
predicts
a
decreased
likelihood
of
complete
pathologic
response
and
survival
for
patients
with
esophageal
adenocarcinoma
treated
with
preoperative
chemoradiation
and
surgery
.
