Signet ring cell histology is associated with unique clinical features butdoes not affect gastric cancer survival

Signet ring cell histology is found in 3 to 39 per cent of gastric cancer c ases and has been reported to be a feature of poor prognosis, although this issue has not been rigorously examined. The objective of this study Was to determine those demographic and clinical variables associated with signet ring cell histology and to determine the effect of signet ring cell histolo gy on survival using multivariate analyses. We studied a historical cohort of consecutive cases of gastric cancer reported to the population-based Cal ifornia Cancer Registries of Orange, San Diego, and Imperial Counties from 1984 through 1994. Factors associated with signet ring cell histology were assessed using chi(2) and logistic regression. Life tables were constructed to assess unadjusted survival and survival differences in patient subgroup s. Multivariate survival was determined using a Cox proportional hazards mo del. Of 3020 patients, 464 (15%) had signet ring cell histology. Patients w ith signet ring cell histology were more likely to be younger than 50 years (odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.6-3.5), less like ly to be male (OR = 0.49; 95% CI = 0.37-0.66), and more likely to have tumo rs of the distal stomach (OR = 2.0; 95% CI = 1.4-3.0). Signet ring cell his tology did not adversely affect unadjusted overall survival, race-stratifie d survival, or stage-stratified survival. Multivariate analysis indicated t hat patients with signet ring cell histology had an insignificant increased risk of dying (relative risk = 1.027; P > 0.10) in comparison with patient s without signet ring cell histology. Patients with signet ring cell histol ogy were more likely to be young women and to have tumors of the distal sto mach. Signet ring cell histology did not impact survival in our group of la rgely advanced gastric cancer cases.