Prognosis of Signet Ring Cells in Upper Digestive Neoplasms
Condition: Signet Ring Cell Carcinoma; Stomach Disease; Oesophagus; Prognostic; Case-control Study
MeSH terms: Carcinoma, Signet Ring Cell; Stomach Diseases
Study type: Observational

Summary: 
      Background • A major increase in incidence of signet ring cell adenocarcinomas (ADCI) of the
      upper digestive tract in western countries

        -  Discordant results in the literature concerning the prognosis value of the presence of
           signet ring cells.

        -  Preliminary data suggesting (i) an advanced stage at time of diagnosis, (ii) more often
           in the form of carcinose, (iii) a more pejorative prognosis, (iv) a recurrence more
           frequent, more quickly, and more often in the form of peritoneal carcinose, (v) a chemo
           resistance (vi) the need for a specific therapeutic strategy compared to non-signet ring
           cell adenocarcinomas.

      Primary objective To test the hypothesis that 5-year survival rate is significantly lower in
      the signet ring cells (SRC) adenocarcinoma when compared to non-SRC adenocarcinoma in the
      upper digestive tract

      Secondary objectives

        -  Impact of neoadjuvant CT on overall survival

        -  Impact and differential diagnostic value of linitis

        -  R0 resection rates

        -  3 years recurrence free survival

        -  Overall 3 years survival

        -  Prognostic factors

        -  Prognostic value of the presence of a minority quota of signet ring cell

        -  Objective response rate after medical treatment (chemotherapy, radiochemotherapy) in
           non-resected patients

        -  Tolerance of (radio) chemotherapy for ADCI

      Methodology Intention to treat retrospective case-control multicentric study A pairing on
      demographic criteria (age, sex, ASA score, center) and tumor criteria (TNM stage) will be
      done to ensure comparability in case control study groups.

      Inclusion criteria All consecutive patients taken care of, for a proven histologically
      adenocarcinoma (ADCI and ADNCI) of the esophagus, the esogastric junction, or the stomach, in
      surgical or medical oncology investigator centers, will be saved in a given database.

      For whom the first consultation took place between January 1997 and January 2010

      Exclusion criteria Histological type other than adenocarcinoma Other localization than
      esogastric junction, esophagus or stomach

      Planned study period The data will be collected over a period from January 1997 to January
      2010.

      The objective is to complete the data collection for summer 2010.
    

Detailed description: 
      stomach cancer signet ring cell carcinoma prognosis chemotherapy
    

Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        Intention to treat retrospective case control multicentric study, Patients will be divided
        into two groups (ADCI or ADNCI) depending on the presence or not of signet ring cells on
        definitive histologic analysis Another analysis based on chemo administration or not will
        be provided A pairing on demographic criteria (age, sex, ASA score, center, TNM stage and
        will be done to ensure comparability in case control study groups.
      
Keywords: stomach disease; signet ring cell carcinoma; chemotherapy; Prognostic