Clinicopathological Study of Rare Histological Types of Colorectal Cancer-Multi-Institutional Questionnaire Study-

Nishimura Y., Sekime T., Kobayashi T., Amikura K., Sakamoto H., Tanaka Y.

doi:10.3862/jcoloproctology.57.132

A multi-institutional questionnaire study was performed to clarify the clinicopathological characteris-tics of rare histological types of colorectal cancer which are other than well and moderately differentiated adenocarcinomas. A questionnaire was sent to the 266 institutions of the Japanese Society for Cancer of the Colon and Rectum, and a total of 109 valid answers (41.0%) were collected. Out of 4, 341 collected cases, 4, 277 cases were eligible, and it was estimated that the incidence was 6.3 % of total colorectal cancers. The 4, 277 cases consisted of 1, 920 poorly differentiated adenocarcinomas (por), 1, 911 mucinous carcinomas (muc), 158 signet-ring cell carcinomas (sig), 125 squamous cell carcinomas (scc), 61 adenosquamous cell car-cinomas (asc), 53 undifferentiated carcinomas (ud), 49 miscellaneous carcinomas including endocrine cell carcinomas (ecc), α-fetoprotein producing carcinomas, and basaloid carcinomas. The average age was 62.8 years in all cases, 66.0 years old in scc cases, which was older than that with other histological types, and 58.1 years old in sig cases, which was younger than the others. Sex ratio was male : female=1 :0.88, whereas in scc cases, female cases were predominant. The location was highly recognized at the anal canal in scc cases, and at the lower rectum in ecc cases. In the macroscopic types sig was more likely to have type 4, whereas ecc was more likely to have type 0 and 5. The depth of invasion was more likely to be si (ai) in sig compared to other types, and sm in ecc. Histological stage was 21.7% at stage III a, 17.7% at stage III b and 32.9% at stage IV in total. Stage IV in sig and ud were 46.3%, 39.2% respectively, showing highly advanced diseases in these groups. The five-year survival rate of resection cases was 43.5% in all, and 52.4%, 50.6%, 38.1 %, 34.1 %, 24.2 % in scc, muc, por, ud and sig cases, respectively. After matching histological stage and curability of each group, ud, sig and por had a worse prognosis than muc, indicating their highly malignant biological characteristics.

Clinicopathological Study of Rare Histological Types of Colorectal Cancer-Multi-Institutional Questionnaire Study-

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