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Clinical significance of signet ring cell rectal carcinoma

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Signet ring cell carcinoma of the rectum (SCCR) is a rare type of rectal carcinoma. This study examined the clinical significance of SCCR.

Patients and methods

From our medical records we retrospectively identified 61 SCCR patients and compared their clinical data and outcomes to those of 144 consecutive patients with non-SCCR mucinous rectal adenocarcinomas (NSMR) and 2,414 consecutive patients with nonmucinous rectal adenocarcinomas (NMR).

Results

The incidence of SCCR was 1.39% of rectal cancers. Mean patient age at onset of SCCR (48.1years, range 15–80) was significantly lower than that for NSMR (57.4 years, 9–88) and NMR (62.6 years, 12–94). The proportion of late stage (TNM III+IV) tumors was significantly higher in SCCR (90%) than in NSMR (69%) and NMR (48%). There were more tumors located in the lower rectum in SCCR (46%) than in NSMR (34%) and NMR (29%). SCCR tumors were significantly larger (5.68±3.84 cm) than NSMR (4.27±1.78 cm) and NMR tumors (3.76±1.71 cm). A higher percentage of patients with SCCR (42.6%) received abdominoperineal resection for treatment. In tumors with TNM stage IV the rate of tumor spread via the hematogenous route was significantly lower in SCCR (18.5%) than in NSMR (43.5%) and in NMR (69%). The rate of tumor spread via seeding to the peritoneum was lower in SCCR (22.2%) than in NSMR (43.5%) but higher than in NMR (2.7%). The rate of tumor spread via the lymphatic route was higher in SCCR (44.4%) than in NSMR (26.1%) and significantly higher than in NMR (12.3%). The 1-, 2-, and 5-year overall SCCR survival rates were 73.9%, 36.3%, and 23.3% respectively, which were significantly poorer than those of NSMR and NMR. For the 28 stage III and R0 SCCR tumors the 1-, 2-, and 5-year disease-free survival rates of SCCR were 84.0%, 44.2%, and 30.3%, respectively, which are comparable with general data of stage III rectal cancer in the world.

Conclusion

Diffuse infiltration of signet ring cells enhances the tendency of mucinous carcinomas of the rectum in more local extension and easier lymphatic spreading but not at peritoneal seeding. Although SCCR had the poorest prognosis, this outcome may be due to the advanced tumor stage rather than histology itself.

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References

  1. Secco GB, Fardeli R, Campora E, et al (1994) Primary mucinous adenocarcinoma and signet ring cell carcinoma of colon and rectum. Oncology 59:1214–1221

    Google Scholar 

  2. Tung SY, Wu CS, Chen PC (1996) Primary signet ring carcinoma of colorectum: an age- and sex-matched controlled study. Am J Gastroenterol 91:2195–2199

    CAS  PubMed  Google Scholar 

  3. Messerini L, Palomba A, Zampi G (1995) Primary signet-ring cell carcinoma of the colon and rectum. Dis Colon Rectum 38:1189–1192

    Google Scholar 

  4. Nozoe T, Anai H, Nasu S, et al (2000) Clinicopathological characteristics of mucinous carcinoma of the colon and rectum. J Surg Oncol 75:103–107

    Article  CAS  PubMed  Google Scholar 

  5. Consorti F, Lorenzotti A, Midiri G, et al (2000) Prognostic significance of mucinous carcinoma of colon and rectum: a prospective case-control study. J Surg Oncol 73:70–74

    Google Scholar 

  6. Morson, BC, Sobin, LH (1976) Histological typing of intestinal tumors, 15. WHO, Geneva

  7. Frost AR, Terahat S, Yeh IT, et al (1995) The significance of signet ring cells in infiltrating lobular carcinoma of the breast. Arch Pathol Lab Med 119:64–68

    Google Scholar 

  8. Kondo A, Ogisu B, Mitsuya H (1981) Signet-ring cell carcinoma involving the urinary bladder: report of a case and review of 21 cases. Urol Int 36:373–379

    CAS  PubMed  Google Scholar 

  9. Laufman H, Sphir O (1951) Primary linitis plastica type of carcinoma of the colon. Arch Surg 62:79–91

    Google Scholar 

  10. Fahl JC, Dockerty MB, Judd ES (1960) Scirrhous carcinoma of the colon and rectum. Surg Gynecol Obstet 3:759–766

    Google Scholar 

  11. Anthony T, George R, Rodriquez-Bigas M, et al (1996) Primary signet ring cell carcinomas of the colon and rectum. Ann Surg Oncol 3:344–348

    CAS  PubMed  Google Scholar 

  12. Nakahara H, Ishikawa T, Itabashi M, et al (1992) Diffusely infiltrating primary colorectal carcinoma of linitis plastica and lymphangiosis types. Cancer 69:901–906

    CAS  PubMed  Google Scholar 

  13. Nissan A, Guillem JG, Paty PB, et al (1999) Signet-ring cell carcinoma of the colon and rectum: a matched control study. Dis Colon Rectum 42:1176–1180

    Google Scholar 

  14. Ochi T, Asai A, Okamura S, et al (1987) Clinicopathological study of colorectal cancer in young adults including a case of cancer family syndrome. Gan No Rhinsho 33:386–391

    CAS  Google Scholar 

  15. Cusack JC, Giacco GG, Cleary K, et al (1996) Survival factors in 186 patients younger than 40 years old with colorectal adenocarcinoma. J Am Coll Surg 183:105–112

    CAS  PubMed  Google Scholar 

  16. Ooi BS, Ho YH, Eu KW, et al (2001) Primary colorectal signet-ring cell carcinoma in Singapore. Anz J Surg 71:703–706

    Article  CAS  PubMed  Google Scholar 

  17. Hamilton SR, Aaltonen LA (2000) Pathology and genetics of tumors of the digestive system. WHO classification of tumors. IARC, Lyon, pp 104–109

  18. Symonds DA, Vickery AL (1976) Mucinous carcinoma of the colon and rectum. Cancer 37:1981–1900

    Google Scholar 

  19. Wu CS, Tung S, Chen P, et al (1996) Clinicopathological study of colorectal mucinous adenocarcinoma in Taiwan: a multivariate study. J Gastroenterol Hepatol 11:77–81

    CAS  PubMed  Google Scholar 

  20. Yamamoto S, Mochizuki H, Hase K, et al (1993) Assessment of clinicopathologic feature of colorectal mucinous adenocarcinoma. Am J Surg 166:77–81

    Google Scholar 

  21. Umpleby HC, Ranson DL (1985) Williamson RC. Peculiarities of mucinous colorectal carcinoma. Br J Surg 72:715–718

    CAS  PubMed  Google Scholar 

  22. Green JB, Timmcke AE, Mitchell WT, et al (1993) Mucinous carcinomajust another colon cancer? Dis Colon Rectum 36:49–54

    Google Scholar 

  23. UICC (1997) TNM classification of malignant tumors, 5th edn. Wiley, New York

  24. Sasaki S, Masaki T, Umetani N, et al (1998) Characteristics in primary signet-ring cell carcinoma of the colorectum, from clinicopathological observations. Jpn J Clin Oncol 28:202–206

    Article  CAS  PubMed  Google Scholar 

  25. Connelly JH, Robey-Cafferty SS (1991) Exophytic signet ring cell carcinoma of the colorectum. Arch Pathol Lab Med 115:134–136

    Google Scholar 

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Acknowledgements

These findings were presented as poster at the meeting of the American Society of Colon and Rectal Surgeons, Chicago, Ill., 3–8 July 2002.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Taipei, Taiwan

    Jinn-Shiun Chen, Pao-Shiu Hsieh, Shin-Yuan Hung, Reiping Tang, Wen-Sy Tsai, Chung-Rong Changchien, Jeng-Yi Wang & Chien-Yuh Yeh

  2. Department of Pathology, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Taipei, Taiwan

    Paul-Yann Lin

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  1. Jinn-Shiun Chen
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  2. Pao-Shiu Hsieh
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  9. Chien-Yuh Yeh
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Correspondence to Chien-Yuh Yeh.

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Chen, JS., Hsieh, PS., Hung, SY. et al. Clinical significance of signet ring cell rectal carcinoma. Int J Colorectal Dis 19, 102–107 (2004). https://doi.org/10.1007/s00384-003-0515-y

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  • DOI: https://doi.org/10.1007/s00384-003-0515-y

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