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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2015; 21(40): 11428-11438
Published online Oct 28, 2015. doi: 10.3748/wjg.v21.i40.11428
Signet-ring cell carcinoma of the stomach: Impact on prognosis and specific therapeutic challenge
Simon Pernot, Thibault Voron, Geraldine Perkins, Christine Lagorce-Pages, Anne Berger, Julien Taieb
Simon Pernot, Geraldine Perkins, Julien Taieb, Department of Gastroenterology and Digestive Oncology, Georges-Pompidou European Hospital, Paris Descartes, Sorbonne Paris Cité, France
Thibault Voron, Anne Berger, Department of Digestive Surgery, Georges-Pompidou European Hospital, Paris Descartes, Sorbonne Paris Cité, France
Geraldine Perkins, Department of Genetic, Georges-Pompidou European Hospital, Paris Descartes, Sorbonne Paris Cité, France
Christine Lagorce-Pages, Department of Pathology, Georges-Pompidou European Hospital, Paris Descartes, Sorbonne Paris Cité, France
Author contributions: Pernot S and Voron T wrote the paper; Perkins G and Lagorce-Pages C contribute to write some sections of the paper and to design illustrations; Berger A and Taieb J contribute to bibliography, and to reviewing the manuscript.
Conflict-of-interest statement: Authors have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Julien Taieb, Professor, Department of Gastroenterology and Digestive Oncology, Georges-Pompidou European Hospital, HEGP, 20 rue Leblanc, 75015 Paris, France. jtaieb75@gmail.com
Telephone: +33-1-56093551
Received: June 29, 2015
Peer-review started: July 3, 2015
First decision: July 20, 2015
Revised: August 14, 2015
Accepted: September 28, 2015
Article in press: September 30, 2015
Published online: October 28, 2015
Processing time: 116 Days and 9.4 Hours
Abstract

While the incidence of gastric cancer has decreased worldwide in recent decades, the incidence of signet-ring cell carcinoma (SRCC) is rising. SRCC has a specific epidemiology and oncogenesis and has two forms: early gastric cancer, which can be resected endoscopically in some cases and which has a better outcome than non-SRCC, and advanced gastric cancer, which is generally thought to have a worse prognosis and lower chemosensitivity than non-SRCC. However, the prognosis of SRCC and its chemosensitivity with specific regimens are still controversial as SRCC is not specifically identified in most studies and its poor prognosis may be due to its more advanced stage. It therefore remains unclear if a specific therapeutic strategy is justified, as the benefit of perioperative chemotherapy and the value of taxane-based chemotherapy are unclear. In this review we analyze recent data on the epidemiology, oncogenesis, prognosis and specific therapeutic strategies in both early and advanced SRCC of the stomach and in hereditary diffuse gastric cancer.

Keywords: Gastric cancer; Signet ring cell carcinoma; Diffuse gastric cancer; Hereditary diffuse gastric cancer; CDH1

Core tip: Contrary to others gastric cancer, the incidence of signet-ring cell carcinoma (SRCC) of the stomach is rising worldwide. SRCC has a specific epidemiology and oncogenesis and has two forms: early gastric cancer, which can be resected endoscopically in some cases and which has a better outcome than non-SRCC, and advanced gastric cancer, which is generally thought to have a worse prognosis and lower chemosensitivity than non-SRCC. Its poor prognosis may be due at least in part to its more advanced stage. Therapeutic strategies are emerging but still controversial, as the benefit of perioperative chemotherapy and the value of taxane-based chemotherapy.