Abstract
Background Signet ring cell carcinoma (SRCC) is a rare subtype of colorectal cancer with significant variations in clinical characteristics and poor prognosis. However, there is limited data available in Pakistan. Therefore, we analyzed to examine the incidence, clinicopathological features, treatments, and outcomes of SRCC in colorectal cancer cases in Pakistan. Methods This study includes 214 primary signet ring cell carcinoma cases in the colon and rectum. All relevant clinical information extracts on demographic details, laboratory results, radiological findings, endoscopy, pathologic diagnoses, surgical interventions, neoadjuvant and adjuvant therapies, and their corresponding outcomes were undertaken from the same online database of hospital and analyzed using SPSS (SPSS Inc., Chicago, IL, USA), Chi-square test, and independent sample Kruskal-Wallis H test. Results The prevalence of SRCC was higher in younger patients (<50 years), 184 (86%). SRCC was more common in advanced stages T3 and T4, with 210 (98%) cases and 106 cases (49.5%) belonging to stage N2. In 27 cases (12.6%), there was already distant metastasis. The most common site of recurrent disease in SRCC patients was the peritoneum in about 50 (51.5%) patients, followed by multi-site metastases involving the lung, liver, bones, and lymph nodes. Conclusion Signet ring cell colorectal cancer (SRCC) manifests in Pakistan at a younger age and is diagnosed at a more advanced stage, often accompanied by peritoneal metastasis with elevated levels of recurrence due to relatively low rates of screening and the absence of national cancer data and guidelines. It is imperative that these issues should be addressed in order to alleviate the burden of this disease in our population.