Primary signet-ring cell carcinoma of the colon and rectum

J · medicine forum Guru Joined: 29 Apr 2005 Posts: 612

http://www.annalssurgicaloncology.org/cgi/content/abstract/3/4/344
Primary signet-ring cell carcinoma of the colon and rectum

T. Anthony, R. George, M. Rodriguez-Bigas and N. J. Petrelli
Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo,
NY 14263, USA.

BACKGROUND: Primary signet-ring cell carcinoma of the colon and rectum is
a rare form of adenocarcinoma of the large intestine. The purpose of this
study was to help better define the natural history of this entity.

METHODS: The medical records of 3,690 patients with colorectal cancer seen
at The Roswell Park Cancer Institute between September 1971 and December
1993 were reviewed. We report on 29 patients with pathologic confirmation
of primary signet-ring cell carcinoma. Patient demographics, clinical, and
histologic parameters were evaluated. Survival was calculated by the
Kaplan-Meier method.

RESULTS: There was a nearly equal distribution of primary signet-ring cell
carcinoma between the right colon and left colon/rectum. In most cases the
tumors were > 6 cm, ulcerated, and involved the full thickness of the
bowel wall. Nodal or metastatic disease was present in 21 of 29 patients
(72%) at the time of diagnosis. Four patients (14%) had synchronous
colorectal adenocarcinomas. Twenty-two patients died of disease
progression. At the time of death, two patients (9%) had failed in the
liver, whereas all 22 patients had peritoneal carcinomatosis.

CONCLUSIONS: Patients with primary signet-ring cell colorectal carcinoma
frequently present with late-stage disease. In 23 of 29 patients, the
disease rapidly recurred or progressed. Peritoneal carcinomatosis is the
most common pattern of failure.

Google