Metastatic colorectal carcinoma with signet-ring cells: Clinical, histological and molecular description from an Association des Gastro-Entérologues Oncologues (AGEO) French multicenter retrospective cohort.

Aged Carcinoma, Signet Ring Cell / genetics Colon / pathology Colorectal Neoplasms / genetics Drug Resistance, Neoplasm / genetics Female France Humans Male Microsatellite Instability Middle Aged Mutation Neoplasm Metastasis / genetics Prognosis Proto-Oncogene Proteins B-raf / genetics Retrospective Studies Survival Rate ras Proteins / genetics

Colorectal cancer Metastatic Molecular Signet-ring cell

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

ISSN: 1878-3562

Titre abrégé: Dig Liver Dis

Pays: Netherlands

ID NLM: 100958385

Informations de publication

Date de publication:
Mar 2022

Historique:

received: 24 05 2021

revised: 21 06 2021

accepted: 27 06 2021

pubmed: 14 8 2021

medline: 11 3 2022

entrez: 13 8 2021

Statut: ppublish

Résumé

Metastatic signet-ring cell colorectal carcinoma is rare. We analyzed its clinicopathological and molecular features, prognostic factors and chemosensitivity. Retrospective study from 2003 to 2017 in 31 French centers, divided into three groups: curative care (G1), chemotherapy alone (G2), and best supportive care (G3). Tumors were most frequently in the proximal colon (46%), T4 (71%), and poorly differentiated (86%). The predominant metastatic site was peritoneum (69%). Microsatellite instability and BRAF mutation were found in 19% and 9% (mainly right-sided) of patients and RAS mutations in 23%. Median overall survival (mOS) of the patients (n = 204) was 10.1 months (95%CI: 7.9;12.8), 45.1 for G1 (n = 38), 10.9 for G2 (n = 112), and 1.8 months for G3 (n = 54). No difference in mOS was found when comparing tumor locations, percentage of signet-ring cell contingent and microsatellite status. In G1, relapse-free survival was 14 months (95%CI: 6.5-20.9). In G2, median progression-free survival (PFS) was 4.7 months (95%CI: 3.6;5.9]) with first-line treatment. Median PFS was higher with biological agents than without (5.0 vs 3.9 months, p = 0.016). mSRCC has a poor prognosis with specific location and molecular alterations resulting in low chemosensitivity. Routine microsatellite analysis should be performed because of frequent MSI-high tumors in this population.

Sections du résumé

BACKGROUND BACKGROUND

Metastatic signet-ring cell colorectal carcinoma is rare. We analyzed its clinicopathological and molecular features, prognostic factors and chemosensitivity.

METHODS METHODS

Retrospective study from 2003 to 2017 in 31 French centers, divided into three groups: curative care (G1), chemotherapy alone (G2), and best supportive care (G3).

RESULTS RESULTS

Tumors were most frequently in the proximal colon (46%), T4 (71%), and poorly differentiated (86%). The predominant metastatic site was peritoneum (69%). Microsatellite instability and BRAF mutation were found in 19% and 9% (mainly right-sided) of patients and RAS mutations in 23%. Median overall survival (mOS) of the patients (n = 204) was 10.1 months (95%CI: 7.9;12.8), 45.1 for G1 (n = 38), 10.9 for G2 (n = 112), and 1.8 months for G3 (n = 54). No difference in mOS was found when comparing tumor locations, percentage of signet-ring cell contingent and microsatellite status. In G1, relapse-free survival was 14 months (95%CI: 6.5-20.9). In G2, median progression-free survival (PFS) was 4.7 months (95%CI: 3.6;5.9]) with first-line treatment. Median PFS was higher with biological agents than without (5.0 vs 3.9 months, p = 0.016).

CONCLUSIONS CONCLUSIONS

mSRCC has a poor prognosis with specific location and molecular alterations resulting in low chemosensitivity. Routine microsatellite analysis should be performed because of frequent MSI-high tumors in this population.

Identifiants

DOI: 10.1016/j.dld.2021.06.031 PMID: 34384712

pubmed: 34384712

pii: S1590-8658(21)00366-2

doi: 10.1016/j.dld.2021.06.031

pii:

doi:

Substances chimiques

BRAF protein, human EC 2.7.11.1

Proto-Oncogene Proteins B-raf EC 2.7.11.1

ras Proteins EC 3.6.5.2

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

391-399

Investigateurs

G Piessen (G)

B Tchoundjeu (B)

M Caulet (M)

P Artru (P)

J Forestier (J)

A Meurisse (A)

S Doa (S)

B Avisse (B)

C Locher (C)

G Billet (G)

B Brieau (B)

G Goujon (G)

J Jezequel (J)

Y Touchefeu (Y)

F Ehrhard (F)

D Vernerey (D)

R Coriat (R)

Informations de copyright

Déclaration de conflit d'intérêts

Conflict of Interest None declared.