{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T01:46:53Z","timestamp":1778896013169,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The results of total neoadjuvant therapy (TNT) for locally advanced rectal cancers (LARC) cannot be extrapolated to signet\u2010ring cell cancers (SRCC) that have an extremely aggressive biology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study comparing long course chemoradiation (CTRT) against short course radiation (SCRT) and 12 weeks of chemotherapy for high\u2010risk LARC. Primary endpoints were treatment failure and disease\u2010free survival (DFS)<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CTRT was given to 74 (59.7%) and SCRT\/Chemotherapy to 50 patients (40.3%). Additional chemotherapy was required in 54.1% and 28%, respectively. Except for nodal staging, no other MRI parameter down\u2010staged. Treatment failures were seen in 33.9% and 25.8% had progression. The peritoneum was the commonest site of progression (59.4%). Of the patients that were surgically explored, 63.7% had R0 resections and pathological complete response was seen in 9.7%. At a median follow\u2010up of 35 months, 56.5% had DFS events with a 3\u2010year DFS of 39.5%. Recurrences were noted in 45.1% after curative resections and the 3\u2010year OS\/DFS of these patients were 67.2%\/56.4%. On multivariate regression, the type of preoperative therapy did not influence treatment failures or DFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SRCC is a very aggressive disease and none of the treatment strategies could show superiority over the other with very high peritoneal progression rates and relapses.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26637","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T14:56:02Z","timestamp":1628175362000},"page":"1417-1430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Optimal neoadjuvant strategy for signet ring cell carcinoma of the rectum\u2014Is TNT the solution?"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3295-0006","authenticated-orcid":false,"given":"Mufaddal","family":"Kazi","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, 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