Prognosis of Signet Ring Cells in Upper Digestive Neoplasms

Study Overview
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Brief Summary
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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
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stomach cancer signet ring cell carcinoma prognosis chemotherapy

Official Title
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Has the Quota of Signet Ring Cells an Influence on Prognosis and Treatment Strategy in the Upper GI Tract Adenocarcinomas?

Conditions
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Signet Ring Cell Carcinoma, Stomach Disease, Oesophagus, Prognostic, Case-control Study

Participation Criteria
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Eligibility Criteria
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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 As they benefit from a medical and/or surgical support (primitive cancer being or not resected), whatever the metastatic or the recurrence situation was. Exclusion Criteria: Histological type other than adenocarcinoma Other localization than esogastric junction, esophagus or stomach

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 95 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Signet ring cell carcinoma<br> | |
| non signet ring cell adenocarcinoma<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 |  | participants are followed until death or time point at 31 september 2010 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 3 year recurrence free survival |  | participants are followed until recurrence or time point at 31 september 2010 | 
| Overall 3 year survival according to tumor stage, node invasion, and tumor localization |  | participants are followed until death or time point at 31 september 2010 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stomach disease, signet ring cell carcinoma, chemotherapy, Prognostic