Nine-Year Recurrence-Free Survival in Gastric Signet-Ring Cell Carcinoma: A Case Report of Laparoscopic Radical...

Gastric signet-ring cell carcinoma (GSRCC) represents 10%-14% of all gastric malignancies. The overall prognosis for GSRCC is poorer compared to other types of gastric cancer, as it is characterized by a high degree of malignancy, rapid progression, and early metastasis (particularly peritoneal metastasis). Current therapies combining surgery and chemotherapy are challenged by tumor invasiveness, drug resistance, and limited targeted options. Herein, we present the case of a 60-year-old male diagnosed with GSRCC who underwent laparoscopic distal radical gastrectomy with D2 lymphadenectomy. Postoperative histopathological analysis confirmed a mixed tumor composition comprising 60% GSRCC and 40% moderately differentiated adenocarcinoma. Following surgery, the patient was administered adjuvant therapy with oxaliplatin and S-1 and metformin enteric-coated tablets for 6 months, followed by 42-month maintenance therapy regimen combining oral S-1 and apatinib and metformin enteric-coated tablets. Over 9 years of follow-up, the patient demonstrated sustained recurrence-free survival (RFS) and achieved clinical recovery. This case underscores the potential of individualized adjuvant therapy in addressing the aggressive biological characteristics of GSRCC and offers a valuable reference for strategies to minimize recurrence in GSRCC patients. Trial Registration: ClinicalTrials.gov identifier NCT01101438.