Colorectal cancers of rare histologic types compared with adenocarcinomas

PURPOSE: To examine clinical characteristics of colorectal cancers of rare histologic types compared with adenocarcinomas. METHODS: Review of a population-based registry with complete ascertainment. RESULTS: There were 7,422 colorectal cancers, 4,900 (66 percent) colonic and 2,522 (34 percent) rectal. Two hundred fifty-five cancers (3 percent) were of nonadenocarcinoma varieties including 75 (33 percent) squamous, 74 (33 percent) malignant carcinoids, 37 (16 percent) transitional cell-like, 25 (11 percent) lymphomas, 9 (4 percent) sarcomas, and 2 (0.9 percent) melanomas. Sixty (1.2 percent) of the colon cancers occurred in the appendix, and proportionately more carcinoids accounted for these tumors. Compared with adeno-carcinomas, colonic and rectal carcinoids and colonic lymphomas accounted for a larger proportion of cancers in the younger age groups. The elderly had proportionately fewer colonic carcinoids. Colonic carcinoids, rectal squamous-cell cancers, and rectal transitional cell-like cancers were more common in women. Colonic lymphomas had a worse prognosis than adenocarcinomas. Survival was better with colonic and rectal carcinoids and rectal transitional cell-like cancers than with adenocarcinomas. CONCLUSIONS: Colorectal cancers of histologic varieties other than adenocarcinoma have distinctive epidemiologic and clinical traits.

[1]  T. C. Sullivan.  Anorectal carcinoid tumors: is aggressive surgery warranted? , 1990, Annals of surgery.

[2]  L. Sobin,et al.  Goblet cell carcinoids and related tumors of the vermiform appendix. , 1990, American journal of clinical pathology.

[3]  N. Dubrawsky.  Cancer statistics , 1989, CA: a cancer journal for clinicians.

[4]  C. Henry,et al.  Primary lymphoma of the large intestine. , 1988, The American surgeon.

[5]  M. Rao,et al.  Flow cytometric DNA analysis of carcinoid tumors of the lleum and appendix , 1992 .

[6]  R. Greenblatt,et al.  Anal intraepithelial neoplasia and anal papillomavirus infection among homosexual males with group IV HIV disease. , 1990, JAMA.

[7]  N. Shepherd,et al.  Human papillomavirus type 16 DNA in anal cancers from six different countries. , 1991, Gut.

[8]  D. Nagorney,et al.  Carcinoid tumor of the appendix: treatment and prognosis. , 1987, The New England journal of medicine.

[9]  J. Alexander,et al.  Primary appendiceal malignancies: rare but important. , 1992, Surgery.

[10]  T. Tong,et al.  Cancer statistics, 1994 , 1994, CA: a cancer journal for clinicians.

[11]  J. Ray,et al.  Rectal carcinoids: The most frequent carcinoid tumor , 1992, Diseases of the colon and rectum.

[12]  A. Grimes,et al.  Carcinoid tumors of the rectum. , 1959, The Journal of the Kentucky Medical Association.

[13]  R. Coates,et al.  Sexual practices, sexually transmitted diseases, and the incidence of anal cancer. , 1987, The New England journal of medicine.

[14]  J. Pringle,et al.  The demonstration of a subset of carcinoid tumours of the appendix by in situ hybridization using synthetic probes to proglucagon mRNA , 1992, The Journal of pathology.

[15]  Berry Re,et al.  Primary lymphoma of the large intestine. , 1988 .

[16]  N. Shepherd,et al.  Primary malignant lymphoma of the colon and rectum. A histopathological and immunohistochemical analysis of 45 cases with clinicopathological correlations , 1988, Histopathology.

[17]  M. Richards.  Lymphoma of the colon and rectum. , 1986, Postgraduate medical journal.

[18]  F. Holmes,et al.  Anal cancer in women. , 1988, Gastroenterology.

[19]  Alexander Jw,et al.  Primary appendiceal malignancies: rare but important. , 1992 .

[20]  P. Trott,et al.  International Classification of Diseases for Oncology , 1977 .

[21]  R. Biggar,et al.  Second primary cancers following anal and cervical carcinoma: evidence of shared etiologic factors. , 1992, American journal of epidemiology.

[22]  S. Zaki,et al.  Human papillomavirus infection and anal carcinoma. Retrospective analysis by in situ hybridization and the polymerase chain reaction. , 1992, The American journal of pathology.