{
  "abstract": "The incidence of early-onset signet ring cell carcinoma (SRCC) of the digestive tract has been increasing; however, its clinicopathological characteristics, treatment modalities, and long-term outcomes remain limited. This study aims to conduct a comprehensive analysis of these aspects utilizing the Surveillance, Epidemiology, and End Results (SEER) database. Patients diagnosed with digestive tract SRCC between 2000 and 2021 were included and categorized into early-onset (age ≤ 50 years) and late-onset (> 50 years) groups. Clinicopathological characteristics were compared between the two groups. Propensity score matching (PSM) was used to address confounding. Overall survival (OS) and cancer-specific survival (CSS) were assessed using Kaplan-Meier curves and Cox regression analysis. A total of 25,390 patients were enrolled, including 5,133 with early-onset and 20,257 with late-onset SRCC. The early-onset group exhibited significantly higher risks of lymph node (45.3%) and distant (50.6%) metastasis compared to the late-onset group, especially in the colon and rectum (P < 0.05). The primary treatment modalities included surgery alone, chemotherapy alone, surgery plus chemotherapy, and no/unknown treatment. Predictors of lymph node metastasis included sex, primary site, and T stage; predictors of distant metastasis included sex, race, primary site, T stage, and N stage. The 1-, 3-, 5-, and 10-year OS rates for early-onset SRCC were 54.0%, 28.1%, 21.9%, and 17.8%, respectively; the corresponding CSS rates were 55.2%, 29.6%, 23.6%, and 19.8%. Multivariate analysis revealed that race, primary site, TNM stage, surgery, and marital status as significant OS and CSS predictors. Early-onset SRCC had better OS and CSS compared to late-onset SRCC (P < 0.001), findings consistently confirmed through PSM analysis at ratios of 1:1, 1:2, and 1:3 for both endpoints. In M0N0 patients, surgery alone was associated with favorable outcomes; in M0N+ patients, surgery alone and surgery plus chemotherapy were associated with comparable outcomes; in M1 patients, surgery plus chemotherapy was associated with improved outcomes. Compared to late-onset SRCC, early-onset SRCC has a higher risk of metastasis but a modestly better CSS, although the survival advantage is attenuated when accounting for competing non-cancer mortality risks. In this observational study, the association between treatment and prognosis varied by disease extent: surgery alone for M0N0, surgery plus chemotherapy for M1, and either strategy for M0N+ showed favorable associations.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterology, Suzhou BenQ Medical Center",
    "Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Fengcheng Zang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qian Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Xiaodan Xu"
    },
    {
      "affs": [
        1
      ],
      "name": "Jian Chen"
    },
    {
      "affs": [
        1
      ],
      "name": "Luojie Liu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3d6gjv4k5ka30.bib",
  "cited_by": 0,
  "doi": "10.1038/s41598-026-73431-9",
  "fulltext_url": "https://doi.org/10.1038/s41598-026-73431-9",
  "id": "3d6gjv4k5ka30",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://doi.org/10.1038/s41598-026-73431-9",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "Q"
    ],
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2740|Gastric Cancer Management and Outcomes"
    ]
  ],
  "openalex": "W7214361356",
  "pdf_url": "https://www.nature.com/articles/s41598-026-73431-9_reference.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-01",
  "publisher": "Nature Portfolio",
  "ris": "https://research.draconitic.com/paper/3d6gjv4k5ka30.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:45:57Z",
      "native_id": "49b8b2e7fed84b37bce12289b5500d0c",
      "source": "doaj",
      "url": "https://doi.org/10.1038/s41598-026-73431-9"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Gastric Cancer Management and Outcomes",
      "subfield": "general"
    }
  ],
  "title": "Prognosis and therapeutic navigation in early-onset digestive tract signet ring cell carcinoma: a clinicopathological integrative study",
  "title_text": "Prognosis and therapeutic navigation in early-onset digestive tract signet ring cell carcinoma: a clinicopathological integrative study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:57Z",
  "url": "https://research.draconitic.com/paper/3d6gjv4k5ka30",
  "venue": "Scientific Reports",
  "versions": []
}