The idea is that Signet Ring Cells are very heterogeneous, so its difficult to compare cases as far as chances of survival matter. But in general the pessimistic Dr Google has a point. Apperently I hosted one of the lesser evil varieties as 4 cycles of CapOx prior to HIPEC surgery did a number on the existing three mets in my peritoneum. Still considered NED since HIPEC dec 2015 (Amsterdam), yet my four surgically proven mets never showed up on 3 CTs and 1 MRI and were even missed during my first surgery (number one was removed unknowingly together with the primairy CRC during my first surgery).
dx at 42yrs, kids 6 and 3, married.
07/15 SR CRC T4,N2,M1 (peritoneum), 8/39, CEA 1.4
09/15 CEA 3 start Sandwich procedure Capox 4rnds around HIPEC
10/15 CEA 5 . Abnormal nodes lungs. Laesies in liver, too small to be identified so cleared for HIPEC
12/15 Hipec 3 tiny -yet alive- mets removed (Douglas pouch). Unexpected LAMN tumor appendix resected. Colostomy, 2nd resc. of sigmoid 0/19.
01/16 CapOx 3x, 1x Mono Cap
05/16 CT: NED CEA 2
08/16 CEA 1
11/16 CT: NED , CEA 1
06/18 NED, CEA <1, CA19-9 7