Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5217
Peer-review started: September 14, 2021
First decision: October 18, 2021
Revised: October 21, 2021
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: June 6, 2022
Gastric signet-ring cell carcinoma (GSRC) is a distinct type of gastric cancer (GC), and its incidence has been steadily increasing. GSRC in early and advanced stages is more frequently observed in younger female patients than in gastric adenocarcinomas.
The effect of female reproductive factors on GSRC tumorigenesis and tumor development remains unclear.
The purpose of this study was to estimate the effects of female reproductive factors on the prognosis of GSRC.
Our study involved 1431 participants who were histologically confirmed with GC with signet-ring cells and underwent curative resections between January 2011 and December 2018 at the Cancer Hospital, Chinese Academy of Medical Sciences, China. Cox multivariable model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between sex factors and survival of GC patients with signet-ring cell carcinoma. Subgroup analyses were conducted by: (1) Body mass index; (2) Signet-ring cell proportion; (3) Adjuvant chemotherapy; (4) Neoadjuvant chemotherapy; (5) Nerve invasion; and (6) Lymphatic vessel invasion to explore if the impact of the sex difference was stronger in certain groups.
The menstrual female subjects had a significantly lower risk of mortality (HR = 0.58, 95%CI: 0.42–0.82) than male participants in the multivariable model. The effect appeared to be more substantial among certain subgroup analyses.
There was a stronger positive association with overall survival in menstrual female patients with GSRC, compared to in male or menopause female patients.
Future studies with a more specific measure of signet-ring cells in GC and more comprehensive long-term outcomes (e.g., the recurrence or chemoresistance, could offer more information) will be needed to verify the conclusion in this study.