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BackgroundPrimary pancreatic signet ring cell carcinoma (PSRCC), an extremely rare histologic variant of pancreatic cancer, has a poor prognosis. This study aimed to investigate the prognostic value of chemotherapy in PSRCC.MethodsPatients with PSRCC between 2000 and 2019 were identified using the Surveillance Epidemiology and End Results (SEER) database. The main outcomes in this study were cancer-specific survival (CSS) and overall survival (OS). The baseline characteristics of patients were compared using Pearson’s Chi-square test. Kaplan-Meier analysis was used to generate the survival curves. Least absolute shrinkage and selection operator (LASSO), univariate and multivariate Cox regression models, and Random Survival Forest model were used to analyze the prognostic variables for OS and CSS. The variance inflation factors (VIFs) were used to analyze whether there was an overfitting problem.ResultsA total of 588 patients were identified. Chemotherapy was an independent prognostic factor for OS and CSS, and significantly associated with OS (HR = 0.33, 95% CI = 0.27–0.40, P ConclusionsChemotherapy showed beneficial effects on OS and CSS in patients with PSRCC and should be recommended in clinical practice.背景：原发性胰腺印戒细胞癌（Primary pancreatic signet ring cell carcinoma, PSRCC）是胰腺癌中极为罕见的组织学亚型，预后极差。本研究旨在探讨化疗对PSRCC患者的预后价值。 方法：本研究利用监测、流行病学与最终结果（Surveillance Epidemiology and End Results, SEER）数据库，筛选出2000年至2019年间确诊的PSRCC患者。本研究的主要结局指标为癌症特异性生存期（cancer-specific survival, CSS）与总生存期（overall survival, OS）。采用Pearson卡方检验比较患者的基线临床特征，通过Kaplan-Meier分析绘制生存曲线。分别采用最小绝对收缩和选择算子（Least absolute shrinkage and selection operator, LASSO）、单因素及多因素Cox回归模型、随机生存森林模型，分析影响OS与CSS的预后变量；采用方差膨胀因子（variance inflation factors, VIFs）评估是否存在过拟合问题。 结果：本研究共纳入588例患者。化疗是影响OS与CSS的独立预后因素，且与OS显著相关（HR = 0.33, 95% CI = 0.27–0.40, P 结论：化疗可改善PSRCC患者的OS与CSS，值得在临床实践中推广应用。