Is XXXX a specific entity among @entity356 ?

@entity1 @entity5 @entity2580 @entity189 @entity420 @entity356
BACKGROUND: The prognosis and chemoresistance of signet-ring cell (SRC) @entity356 have been reported and debated, and the utility of perioperative chemotherapy for such a @entity5 has been questioned . This study was performed to assess the impact of the SRC type on survival following resection of @entity356 , and to assess whether the prognostic factors (including perioperative chemotherapy) for non-SRC @entity420 differed from those for SRC @entity420 . METHODS: 1799 cases of @entity420 that were consecutively treated from 1997 to 2010 in 19 French centers by subtotal or total gastrectomy were included in a retrospective study. A D2 lymphadenectomy was performed for @entity5 , and a modified D2 for upper @entity5 . SRC @entity420 was diagnosed based on the presence of @entity189 cells containing mucin. RESULTS: A total gastrectomy was performed in 979 (54.4  %) @entity1 . SRC @entity420 was diagnosed in 899 (50  %) @entity1 . @entity1 with an SRC @entity5 were more frequently female, younger, and malnourished, had lower ASA scores, and had larger @entity5 than non-SRC @entity1 . Median survival in @entity1 with @entity2580 was 51  months, as compared to 26  months in @entity1 with @entity2580 (p  <  0.001). At multivariate analysis, SRC type remained an independent adverse prognostic factor (HR  =  1.182). Factors that were prognostic in the SRC subgroup but not in the non-SRC subgroup were age >60  years, linitis, and involvement of adjacent organs. In contrast to non-SRC @entity5 , pre- and postoperative chemotherapy did not significantly impact on survival following resection of SRC @entity420 . CONCLUSION: In comparison to non-SRC @entity420 , the SRC type has a worse prognosis, different prognostic factors, and is only poorly sensitive to perioperative chemotherapy. Non-SRC and SRC @entity420 should be considered different entities in future therapeutic trials.
