Systematic review of risk factors, prognosis, and management of colorectal signet-ring cell carcinoma

Table 2 Overview of articles reporting on tumor characteristics at the time of diagnosis

Ref.	Mean tumor size (cm)	LNM	Stage III or IV	% M+
Tawadros et al[13], 2015	5.2 vs 4.8 MA vs 4 OA (P < 0.001)	60.8% vs 51.4% MA vs 35% OA (P < 0.001)	NA	24.3% vs 15.2% MA vs 12.3% OA (P < 0.001)
Song et al[25], 2017	NA	35.5% vs 11.6% MA vs 18.4% AC (P < 0.001)	NA	NA
Wei et al[41], 2016	NA	NA	54/61 (88.5%)	NA
Wu et al[9], 2018	NA	NA	NA	NA
Hartmann et al[16], 2013	NA	NA	57% mucin-rich vs 100% mucin-poor (P = 0.005); 44% MSI-H vs 87% MSS (P = 0.0012)	NA
Pande et al[54], 2008	NA	NA	74.2% vs 65% MA vs 70.5 CMA vs 63% OA (P = 0.75)	17/39 (43.6%) vs 30% MA vs 32.4% CMA vs 35% OA
van Oudheusden et al[59], 2015	NA	N2: 62.5% vs 36.1% (P = 0.04)	NA	NA
Wu et al[10], 2019	NA	63.3% vs 45.1% MA vs 36.1% OA (P < 0.001)	3231 (78%) vs 52.3% MA vs 44.7% OA (P < 0.001)	1595 (38.5%) vs 20.3% vs 19% (P < 0.001)
Hyngstrom et al[19], 2012	NA	NA	80% vs 52% MA vs 44% OA (P < 0.01)	NA
Hugen et al[17], 2015	NA	NA	75.2% vs 47.7% (MA) vs 43.6% OA P < 0.0001	NA
Shi et al[61], 2019	NA	60.8% vs 35.1% (P < 0.001)	76.04 vs 44.05% (P < 0.001)	39.13% vs 19.08% (P < 0.001)
Kang et al[12], 2005	NA	NA	80.9 % vs 52.8% (MA; P < 0.0001) vs 49.5% OA (P < 0.0001)	NA
Ciarrocchi[4], 2014	5.6 ± 3.1 (5.4 ± 4.9 rectum vs 5.7 ± 2.7 colon; P = 0.235)	NA	1123 (76%) (144 (72%) vs 979 (76%; P = 0.193)	NA
Huang et al[26], 2016	> 4 cm: 67.9%	74.90%	III: 74.9%	NA
Ling et al[50], 2017	> 5 cm: 45.3% vs 43.2% MA vs 31.1% OA (P = 0.372 vs MA. P < 0.001 vs OA)	NA	Stage III: 79.4% vs 57.1 MA (P < 0.001) vs 52.8 OA (P < 0.001)	NA
Simkens et al[38], 2016	NA	NA	NA	NA
Razenberg et al[62], 2015	NA	62% vs 60% MA vs 59% OA. Nx: 30% vs 25% MA vs 28% OA (P < 0.0001)	100%	NA
Wu et al[11], 2017	53.5 ± 25.1	NA	Stage III: 241/292 (82.5%)	NA
Thota et al[30], 2014	NA	46.5% vs 38% MA vs 27% NMA. Unknown: 32.5% vs 14% MA vs 29% NMA	61.2% vs 44.6% MA vs 44.5% NMA. Unknown: 22.3% vs 16% MA vs 32% NMA	NA
Tamhankar et al[51], 2016	NA	NA	91.20%	39.40%
Nitsche et al[33], 2013	NA	71% vs 44% (P < 0.001)	86% vs 48% (P < 0.001)	35% vs 18% (P < 0.001)
Kakar and Smyrk[44], 2005	> 5 cm: 52/72 (72%)	NA	55/72 (76.4%)	NA
Yun et al[63], 2017	NA	NA	69% vs 43% (P < 0.001)	NA
Sung et al[21], 2008	6.64 ± 2.4 vs 10.35 ± 55.2 MA (P = 0.608)	57/65 (88%) vs 130/266 (49%) (P < 0.0001)	58/65 (89%) vs 138/266 (52%) MA (P < 0.0001)	NA
Chen et al[6], 2004	5.7 ± 3.8 vs 4.3 ± 1.8 MA vs 3.8 ± 1.7 (NMA; P < 0.001)	NA	90% vs 69% (MA; P = 0.013) vs 49% (NMA; P < 0.001)	25/61 (41%) vs 44/144 (30%; MA) vs 311/2414 (13%) NMA
Wang et al[43], 2016	NA	52/59 (88.1%)	NA	14/59 (23.7%)
Nissan et al[18], 1999	NA	NA	60% vs 60% CG vs 45% CRC	30%
Liang et al[31], 2018	NA	26 (70.3%)	33/37 (89.2%)	16/37 (43%)
Korphaisarn et al[46], 2019	NA	NA	NA	100%
Lee et al[52], 2007	NA	NA	79.9% vs 55% MA vs 64.7% poorly differentiated OA (P = 0.003)	37.1% vs 15% MA vs 25% poorly differentiated OA
Bittorf et al[8], 2004	NA	NA	20/24 (83%) resected specimens vs 2089/4231 (49%) resected specimens (P = 0.002)	15/34 (44%) vs 912/4458 (21%; P = 0.002)
Messerini et al[32], 1995	> 5 cm: 22/34 (64.7%)	NA	Dukes stage C: 21/34 (61.8%). D: 3/34 (8.8%). Combined: 24/34 (70.6%)	NA
Bademci et al[28], 2019	4.6 ± 1.8	17 (68%)	22 (64.7%)	NA
Chua et al[53], 2009	NA	Colorectal: 13/15 (87%). Appendiceal: 11/18 (61%)	NA	NA
Kakar et al[45], 2012	NA	NA	79% vs 62% MA vs 34% OA (P < 0.001)	NA
Barresi et al[27], 2016	NA	NA	28/32	NA
Chew et al[22], 2010	NA	25 (89%) vs 101 (61%) MA vs 1320 (52%) OA (P = 0.002)	38 (94%) vs 112 (67%) MA vs 1426 (56%) (P < 0.001)	13 (43%) vs 45 (27%) MA vs 520 (20%) (P = 0.009)
Nitsche et al[1], 2016	NA	NA	26/30 (87%) vs 48% MA vs 55% OA (P < 0.001)	12/30 (40%) vs 25% MA vs 22% OA (P = 0.015)
Anthony et al[7], 1996	6 (0.8-15)	13/29 (45%)	21/29 (72%)	8/29 (28%)
Song et al[64], 2009	5.52 ± 3.36 vs 5.52 ± 1.823 MA vs 4.62 ± 268 NMA (P < 0.001)	18 (72%) vs 59% MA vs 51% NMA	20 (75%) vs 59% MA vs 52% NMA (P < 0.01)	NA
Belli et al[20], 2014	7 ± 3.6	NA	20/22 (91%)	10/22 (45%)
Zhang et al[65], 2020	SRCC + MA: > 5 cm: 50%	SRCC + MAC: 74.4%	SRCC + MAC: 83.3%	SRCC + MAC: 23.3%
Wang et al[39], 2019	NA	NA	NA	38% vs 20%
Song et al[66], 2019	NA	80% vs 65.1 mixed vs 47.1 cluster vs 32.1% strip (P < 0.001)	85% vs 65.1% mixed vs 48.4% cluster vs 35.8% strip (P = 0.006)	15% vs 7.0% mixed vs 9.0% cluster vs 6.2% strip (P = 0.603)
Mizushima et al[36], 2010	7.2 ± 3.8 vs 4.4 ± 2.2 (well/moderately differentiated) vs 5.6 ± 2.7 (poorly differentiated/MA)	14/19 (73.7%)	16/19 (84.21%) (SRC differentiation)	7/19 (36.8%) vs 14.5% well/moderately differentiated vs 29.9% (poorly differentiated/mucinous) (SRC differentiation)
Foda et al[42], 2018	NA	84.2% vs 57.2 MA vs 60.7% OA with mucinous component vs 42.6% OA	84.2% vs 57.1% MA vs 60.7% AWNC vs 44.7% OA	NA
Lee et al[29], 2015	7.59 ± 2.9 vs 5.37 ± 2.19 (P = 0.003)	12/15 (80%) vs 60/75 (80%; P = 0.994)	80% vs 80%	NA
Imai et al[67], 2013	NA	9/15 (64.3%) vs 46.8% MA vs 78.4% poorly differentiated OA vs 54% well or moderately differentiated OA	11/15 (73.3%) vs 50% vs 81.1% vs 54%	NA
Psathakis et al[15], 1999	NA	NA	13/14 (92.8%) vs 30/56 (50%; P < 0.05)	NA
Pozos-Ochoa et al[37], 2018	NA	75% vs 50% (P = 0.040)	91.7% vs 75% (P = 0.248)	NA
Sasaki et al[14], 1998	> 8 cm: 11/11 (100%) vs 6/29 (21.4%; P < 0.00001)	NA	9/22 (81.8%) vs 17/29) (58.6%) (stages I-III/stage IV P < 0.01)	NA
Ooi et al[23], 2001	NA	NA	Dukes stage C or D: 9/9 (100%)	2/9 (22%)
Secco et al[68], 1994	NA	NA	Duke C/D: 100% vs 56.4% MA vs 42.4% OA	NA

LNM: Lymph node metastases; SRCC: Signet-ring cell cancer; MA: Mucinous adenocarcinoma; OA: Ordinary/conventional adenocarcinoma; NA: Not applicable; NMA: Non-mucinous adenocarcinoma; CMA: Component of mucinous adenocarcinoma; MAC: Mucinous adenocarcinoma; CRC: Colorectal cancer; AWNC: Adenocarcinoma with mucinous component.