Clinicopathological characteristics and grading of poorly differentiated colon adenocarcinoma (Por) were discussed. A total of 1074 patients with colon cancer underwent surgical treatment at Kurume University Hospital in Fukuoka, between 1985 and 2005. Clinicopathological characteristics of 88 cases (8%) of Por and 986 cases (92%) of well differentiated tubular adenocarcinoma/moderately differentiated tubular adenocarcinoma (Tub1/Tub2) were studied. A multiple classification analysis showed that Por was more frequently observed in the right colon than Tub1/Tub2, and that the ratio of macroscopic types 3 and 4 was significantly higher in Por. Significant differences were also observed with regard to lymph vessel and perineural invasion. There were no significant differences between recurrence-free survivals of Por and Tub1/Tub2 after radical resection in Stages II and III. Recurrence of Por was significantly higher in peritonea and lymph nodes. These findings indicate that Por, which is generally considered to have a poor prognosis, has a similar recurrence rate to that of Tub1/Tub2 after the performance of radical surgery.

In many countries, treatment for cancer is performed based on staging systems in which the degree of cancer development is defined objectively. A common staging system is thus needed to compare outcomes. The staging system for colorectal cancer in Japan has been made to enhance consistency with the TNM classification, and the categorization of metastatic lymph nodes and depth of invasion have been revised in recent years. Although these are important factors that determine disease stage, relationships between each factor and recurrence have shown differing prognoses. In our retrospective study, the prognosis of a group with only one metastatic lymph node was significantly better compared to a group with ≧2 metastatic lymph nodes. In addition, rectal cancer with mesorectal extension >5 mm showed low relapse-free survival rates and high recurrence rates. The validity of staging systems should thus be inspected from various perspectives.

The aim of this study was to elucidate whether fecoflowmetry (FFM) could evaluate more detailed evacuative function than anorectal manometry by comparing between FFM or anorectal manometric findings and the clinical questionnaires and the types of surgical procedure in the patients who received anal-preserving surgery. Fifty-three patients who underwent anal-preserving surgery for low rectal cancer were enrolled. The relationships between FFM or the manometric findings and the clinical questionnaires and the types of procedure of anal-preserving surgery were evaluated. There were significant differences between FFM markers and the clinical questionnaire and the types of the surgical procedure, whereas no significant relationship was observed between the manometric findings and the clinical questionnaire and the types of the surgical procedure. FFM might be feasible and useful for the objective assessment of evacuative function and may be superior to manometry for patients undergoing anal-preserving surgery.

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