Effects Of Different Signet-ring Cell Carcinoma Components On The Prognosis Of Colorectal Cancer

Purpose: Colorectal signet-ring cell carcinoma(SRCC)has been associated with poor prognosis,while the prognosis of patients with partial SRCC(PSRCC)has been rarely reported.This study aimed to analyze the prognosis of patients with different SRC composition and establish a prediction model.Methods: A total of 91 patients with SRC component were included and divided into two groups: SRCC group(SRC composition > 50%;n=41)and partial SRCC(PSRCC)group(SRC composition ≤ 50%;n=50).COX regression model was used to identify independent prognostic factors for overall survival(OS).A predictive nomogram was established and compared with the 7th AJCC staging system.Results: After a median follow-up of 16 months,no significant difference in OS was observed in both groups.preoperative CEA level,p N stage,M stage,preoperative ileus,and adjuvant chemotherapy were independent prognostic risk factors for OS(p <0.05).A nomogram for predicting overall survival of colorectal SRCC was established with a C-index of 0.800,and it showed better performance than that of the 7th AJCC staging system(p <0.001).Conclusion: Ratio of SRC component was not an independent prognostic factor of OS.Those patients with less than 50% of SRC component should be given the same clinical attention.A predictive nomogram for survival basing on five independent prognostic factors was developed,which showed better performance than the 7th AJCC staging system.It is helpful for individualized prognosis prediction and risk assessment.