Abstract

Poorly differentiated adenocarcinomas or signet ring cell carcinomas (poorly differentiated group) are relatively rare in the large intestine compared to well or moderately differentiated adenocarcinomas (differentiated group). We compared the poorly differentiated group with the differentiated group to elucidate clinicopathological features of the poorly differentiated group. Among 292 resected patients with colorectla carcinoma, 28 (10%) patients had tumor belonged to the poorly differentiated group. The incidence of a primary tumor locating in the proximal colon was higher in the poorly differentiated group than that in the differentiated group. The incidences of microscopic lymph node metastasis, peritoneal dissemination and macroscopic invasion to the adjacent organs were significantly (p<0.05) higher in the poorly differentiated group than these in the differentiated group. Particularly, the rate of n4(+) cases was markedly higher in the poorly differentiated group. The prognosis of the poorly differentiated group was significantly (p<0.05) worse than that of the other thought the tumors were resected curatively or lymph node metastasis was n(-), nl(+) or n2(+). We conclude that the poorly differentiated adenocar-cinomas are biologically more malignant than the differentiated adenocarcinomas. Thus, multimodified therapies are necessary in order to improve the prognosis of the poorly differentiated adenocarcinoma, if curative resection is possible.

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