Prognostic factors for men with primary “signet ring” cancer of the prostate

In January last year we provided summary information about a rare form of prostate cancer known as “signet ring” cancer of the prostate (SRCP). A new report has now added to knowledge about this type of prostate cancer.

Wang et al. interrogated the national Surveillance, Epidemiology, and End Results (SEER) database for all known cases of primary SRCP  — with the following results:

  • A total of 93 patients were diagnosed and treated for pathologically confirmed SRCP between 1980 and 2004.
  • These 93 patients represented 0.02 percent of all cases of prostate cancer in the SEER database over that 25-year time frame.
  • The age-adjusted incidence of SRCP was extremely low at 0.0088 per 100,000 (about 1 in 11 million men) over the study period.
  • The average (mean) age of the patients was 70 ± 11 years.
  • The average (median) age of the patients was 69 years (range, 40 to 92 years).
  • 77/93 patients (82.8 percent) had poorly or undifferentiated histology.
  • 13/93 patients (13.9 percent) patients had metastatic disease at time of presentation.
  • 1-, 3-, and 5-year cancer-specific survival rates were 94.6, 89.6, and 83.8 percent, respectively.
  • The following factors were predictive of worse cancer-specific survival:
    • Younger age (40-50 vs >70 years, P = 0.01)
    • More advanced tumor stage (distant vs local/regional disease, P = 0.02)
    • Earlier date of diagnosis (before 1995 vs after 1995, P = 0.01)

The authors conclude that, “Despite more aggressive cancer therapy, younger [SRCP] patients had a worse cancer-specific survival.” Surprisingly, however, the cancer-specific survival rate for the entire cohort was high. Only those patients diagnosed with metastatic disease at the tim eo presentation appear to have had a 5-year survival of < 50 percent.

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