Theme |
Endocrine cell tumors of the colorectum: Difference in concept between WHO classification and Japanese classification |
Title |
Diagnosis and treatment of colorectal endocrine cell carcinoma |
Author |
Keiji Matsuda |
Department of Surgery, Teikyo University School of Medicine |
Author |
Takahiro Yagi |
Department of Surgery, Teikyo University School of Medicine |
Author |
Yoshihisa Fukushima |
Department of Surgery, Teikyo University School of Medicine |
Author |
Ryu Shimada |
Department of Surgery, Teikyo University School of Medicine |
Author |
Tsuyoshi Ozawa |
Department of Surgery, Teikyo University School of Medicine |
Author |
Tamuro Hayama |
Department of Surgery, Teikyo University School of Medicine |
Author |
Takeshi Tsuchiya |
Department of Surgery, Teikyo University School of Medicine |
Author |
Keijiro Nozawa |
Department of Surgery, Teikyo University School of Medicine |
Author |
Yojiro Hashiguchi |
Department of Surgery, Teikyo University School of Medicine |
[ Summary ] |
Endocrine cell carcinoma of the colon is diagnosed by confi rming differentiation into endocrine cells for cases diagnosed as poorly differentiated adenocarcinoma or undifferentiated carcinoma in HE stained specimens, distinguishing it from carcinoid tumors. At the time of diagnosis, metastasis has already occurred in 69-94 % of cases, and the frequency of Stage Ⅳ is as high as 33-65 %. On the other hand, the preoperative diagnosis rate for endocrine cell carcinoma is as low as 6-24 %. Treatment is basically resection with lymph node dissection. However, this condition recurs early postoperatively and often develops rapidly. In recent years chemotherapy has been used including drugs commonly employed for colorectal cancer (bevacizumab, oxaliplatin, irinotecan). However, response rates are low and there is no established chemotherapy regimen. The prognosis for these patients is very poor, and median survival times are 10 to 11.4 months. |