Trends of incidence and survival in patients with gastroenteropancreatic signet ring cell carcinoma: an analysis from the Surveillance, Epidemiology, and End Results program

Hui Li, Zhen Zong, Taicheng Zhou, Lina Sun, Anan Wang, Kunhe Zhang, Chenghao Yi


Background: The epidemiology and clinical outcome of gastroenteropancreatic signet ring cell carcinoma (SRC) were not well illustrated. We aimed to explore the long-term epidemiology and predictors affect the overall survival (OS) of patients with SRC in gastrointestinal tract and pancreas.
Methods: Annual age-adjusted incidence, OS and survival trend of patients with gastroenteropancreatic SRC were evaluated in the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2014. Multivariate Cox hazards regression model were used to identify predictive factors of the entity disease.
Results: Of the 24,613 patients in the cohort, 54.0% (13,295) were male gender. The age-adjusted incidence of SRC from January 2000 to December 2014 was decreased slightly. This trend appeared across all stages, grades and all the tumor locations, excerpt for esophagus and appendix. In regard to the incidence of SRC in gastrointestinal tract and pancreas, the stomach carried a higher incidence than other sites. Different primary site, stage and grade, and age of clinical diagnosis as well as time period of diagnosis were all found to have the significant median OS by multivariable analysis. Five years’ OS of gastroenteropancreatic SRC was improving gradually between 2000–2014. In subgroups stratified by tumor stages and grades, the most pronounced improvement of survival over the same interval was observed in the early-stage and well differentiation SRC.
Conclusions: SRC in a heterogeneous US population tended to carry the poor prognosis with a high proportion of distant metastasis. The poor prognosis of SRC was mainly caused by high tumor stages and poor differentiation at diagnosis.