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Signet ring cell carcinoma (SRCC) is a histological type of gastric cancer. This tumour is quick to grow and metastasise. The disease most often affects people in their 50s and 60s. It accounts for about 30% of all cases of gastric cancer. Without timely treatment, the prognosis for survival is unfavourable. Read our article about how the management of signet ring cell carcinoma and which clinics show the best results of oncotherapy.

 

 

What is gastric signet ring cell carcinoma?

перстневидно клеточная карцинома желудка

Signet ring cell carcinoma is an aggressive oncology that rapidly metastasises to other organs. The tumour gets its name from the structure of the cancer cells. Under the microscope, the cells are shaped like rings. 

 

The exact causes of this form of gastric cancer are unknown. The main risk factors for developing papillary cell carcinoma include a poor diet, a mutation in the CDH1 gene and chronic gastric pathologies. 

 

The disease may be asymptomatic or cause minor discomfort for some time. As the tumour progresses, patients show the following signs:

 

    иконка галочки abdominal pain,  

    иконка галочки heartburn,  

    иконка галочки nausea and vomiting,  

    иконка галочки the feeling of fullness in the stomach,  

    иконка галочки decreased appetite,  

    иконка галочки enlarged abdomen,  

    иконка галочки weight loss,

    иконка галочки blood in the stool.

Diagnosis of signet ring cell carcinoma

“The gold standard for diagnosing SRCC is gastroscopy – an endoscopic examination of the stomach. During this procedure, the mucosa of the upper gastrointestinal tract is examined using an endoscope. If the doctor finds abnormal areas, cells are taken for laboratory examination – a biopsy. 

    Gastroscopy can be combined with an ultrasound scan. This is called an endo-ultrasound. It allows a more detailed look at the walls of the stomach, the surrounding tissues and the lymph nodes.

    Computed tomography, magnetic resonance imaging and PET-CT are used to determine the stage of the neoplasm and to detect metastases of carcinoid cancer.

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What treatments are available for signet ring cell carcinoma?

перстневидно клеточная карцинома диагностика и лечение

The oncotherapy programme for gastric cancer is tailored to each patient on an individual basis. A multidisciplinary team of doctors cooperate on its development – oncologists, surgeons, radiologists, chemotherapists, anaesthetists, etc. The methods used to treat the disease are:

 

    иконка галочки surgical intervention,  

    иконка галочки radiotherapy,  

    иконка галочки chemotherapy,  

    иконка галочки targeted drugs.  

 

If the carcinoma is resectable, surgery is most usually employed. Removal of most of the stomach with lymphadenectomy is the priority treatment for this oncopathology. 

 

The technique and type of surgery depend on the location and size of the tumour. If the proximal (upper) or middle third of the stomach is affected, a complete resection of the organ is recommended. This is necessary because the likelihood of recurrence of the rest of the stomach is high. 

 

Subtotal resection (removal of ⅘ part of the organ) with a negative margin is suitable for patients with distal (lower) gastric carcinoma. 

 

In both proximal and distal gastric cancers, the surgical procedure must include resection of at least 15 lymph nodes.

 

The surgery is performed through an open incision or laparoscopically through 3-5 peritoneal punctures. It is also possible to use the da Vinci robotic system.

 

Unless metastases to the spleen are suspected, the spleen should be preserved. However, in advanced proximal gastric tumours (pylorus and upper body), even if there are no metastases, splenectomy is recommended. This is because the risk of residual damage to the spleen nodes is around 15-20%. 

лечение рака желудка 2 стадия

Conservative treatments for signet ring cell carcinoma of the stomach

перстневидноклеточный рак желудка

Patients are given chemical and/or radiation therapy along with surgery. Chemotherapy is administered before and after surgery. It reduces the size of the tumour or destroys residual cancer cells after resection. A combination of drugs is used for this purpose.
 

Generally, 3 courses of chemotherapy are carried out before and after surgery to maximise the therapeutic effect.

 

Radiation is combined with chemotherapy. This approach to treatment makes it possible to kill the metastases and control the disease. If the chemo-radiotherapy does not work, the patient is given targeted drugs. These drugs target the tumour without damaging healthy organs. For carcinoma of the stomach, a targeted drug from the HER2 inhibitor group is recommended.

 

Treatment prognosis for paracellular cancer 

With early diagnosis and comprehensive treatment, the prognosis for survival is improved. If the disease is detected at an early stage, the 5-year survival rate is around 80%. In stages 2 and 3 the rates are 68% and 31% respectively. In stage 4 gastric carcinoma, the prognosis for 5-year survival is around 5%.

Which clinics treat pancreatic cancer of the stomach abroad?

 

 

 

 

    Summary

    иконка галочки Signet ring cell carcinoma of the stomach accounts for 30% of all cases of cancer of this organ. It is an aggressive disease with rapid metastasis. The tumour is most commonly diagnosed between the ages of 50 and 60.

    иконка галочки The initial stages are asymptomatic. As cancer progresses, patients experience discomfort and a feeling of fullness in the stomach. Nausea, vomiting, heartburn, weight loss and blood in the stool are also added to these symptoms.

    иконка галочки Gastroscopy and endo ultrasound, followed by a biopsy of abnormal tissue, are used to diagnose gastric cancer. CT, MRI and PET-CT are used to determine the stage and characteristics of the tumour.

    иконка галочки Surgery is the first line of treatment for paracellular carcinoma of the stomach. It involves removing part or all of the organ along with the lymph nodes. Chemotherapy and/or radiotherapy are recommended to reduce the size of the tumour or to destroy residual cancer cells after resection. Metastases and recurrent gastric cancer are treated with targeted drugs.

    иконка галочки The prognosis for oncological treatment of the disease depends directly on the degree of spread of the malignant process. In the initial stages, 8 out of 10 patients pass the 5-year survival threshold. For advanced disease, the survival rate is less than 5%.

    иконка галочкиMedical tourists in need of gastric signet ring cell carcinoma choose clinics in Turkey, Germany, Spain, Israel and Korea. The following hospitals are particularly popular: Liv, Sheba, Medicana, SoonChunHyang, Navarra, and Teknon.

 

To go abroad for gastric carcinoma treatment, please contact the medical coordinators of the MediGlobus international medical platform. Our specialists will assist you in all stages of your treatment abroad and will be in touch with you 24/7.

How do I treat an aggressive signet ring cell carcinoma of the stomach?

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Источники

  1. Annals of Translational Medicine
  2. PLOS One

 


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