Clinicopathological Study of Type 4 (Diffuse Infiltrative Type)Colorectal Cancer

Yukinori Kurokawa, Nobuteru Kikkawa, Hideyuki Mishima, Kazumasa Fujitani, Eisei Shin, Toshiro Sawamura, Isamu Nishisho, Yasunori Hasuike, Kenji Kobayashi and Toshimasa Tsujinaka

Department of Surgery, Osaka National Hospital

Clinicopathological characteristics of type 4 (diffuse infiltrative type) colorectal cancer (n=15) were compared to those of other types of colorectal cancer (n=2,912) resected during the last 34 years. The mean age of type 4 cancer patients was 54.5 year-old, and the most common first symptoms were constipation and abdominal pain. The average diameter of type 4 tumors was 9.5cm, that was significantly larger than that in other types. The depth of type 4 tumors unexceptionally reached to the subserosa or deeper layer. The rates of peritoneal dissemination, lymph node metastasis and poorly differentiated type were 33.3%, 93.3%, and 53.3%, respectively, those were significantly higher than those in other types. The prognosis of type 4 cancer was extremely poor, because the 3-year survival rate of 14 cases except the last case was 7.1%, and all 14 cases died of original disease within 4 years. The cases of scirrhous type had the best prognosis among the 3 types according to the Kikkawa classification. When univariate and multivariate analyses were carried out, the Kikkawa classification was the significant prognostic factor of type 4 cancer.

Key words
diffuse infiltrative colorectal cancer, primary linitis plastica type, scirrhous type

Reprint requests
Yukinori Kurokawa Department of Surgery, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006 JAPAN

Accepted
October 26, 1999

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