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Master Thesis

Les adénocarcinomes à cellules indépendantes : une entité particulière au sein des cancers gastriques ?

Abstract : Background: Specific prognosis and chemoresistance of signet-ring cell (SRC) gastric adenocarcinoma have been reported and debated, questioning utility of perioperative chemotherapy for these tumors. Objective: To assess the impact of SRC on survival in resected gastric adenocarcinoma and to assess if prognostic factors of SRC and Non-SRC adenocarcinoma including the use of perioperative chemotherapies do differ. Methods: 1799 adenocarcinoma consecutively treated from 1997 to 2010 in 19 French centers by subtotal or total gastrectomy were included in a retrospective study. A D2 lymphadenectomy was performed for antropyloric tumors and a modified D2 for upper tumors. The diagnosis of SRC was based on the presence, on resected specimen, of isolated carcinoma cells containing mucin. Results: A total gastrectomy was performed in 979 (54,4%) patients. SRC type was diagnosed in 899 (50%) patients. Patients with SRC tumor were more frequently female, younger, malnourished, with lower ASA score and had more extended tumors than Non-SRC patients. Median survival in patients with Non-SRC carcinoma was of 51 months compared to 26 months in patients with SRC carcinoma (p <0.001). At multivariate analysis, SRC type remained an independent adverse prognostic factor (HR=1.182). The specific prognostic factors in SRC subgroup, lacking in Non-SRC, were age > 60 years, linitis and involvement of adjacent organs. Contrary to Non-SRC tumors, pre and postoperative chemotherapies did not significantly impact survival of resected SRC adenocarcinoma. Conclusion: SRC-type exhibit worse prognosis, its own prognostic factors and seems poorly sensitive to perioperative chemotherapies. Non-SRC and SRC adenocarcinoma should be considered as different entities in future therapeutic trials.
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Submitted on : Friday, March 20, 2015 - 4:21:45 PM
Last modification on : Monday, October 19, 2020 - 11:06:34 AM
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  • HAL Id : dumas-01132575, version 1


Thibault Voron. Les adénocarcinomes à cellules indépendantes : une entité particulière au sein des cancers gastriques ?. Médecine humaine et pathologie. 2014. ⟨dumas-01132575⟩



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