Shi T, Song X, Liu Q, et al. - Using the Surveillance, Epidemiology, and End Results database, researchers assessed whether palliative gastrectomy plus chemotherapy (PG+C) confers a survival benefit in patients with metastatic gastric signet ring cell carcinoma (SRCC). They found that PG followed by C vs C alone could be beneficial for at least a selective group of stage IV gastric SRCC patients. In multivariate analysis, a link of multiple metastatic sites with increased mortality risk was found. Improved median survival time was observed in metastatic SRCC taking PG+C vs PG/C alone (13 vs 7 months). In subgroup analysis, prolonged overall survival was observed in correlation with PG+C vs chemotherapy alone in 13 of 17 groups of metastatic SRCC patients, this was true particularly for those with only one metastatic site.