Colorectal squamous cell carcinoma: a rare tumor with poor prognosis.
OBJECTIVE
Primary squamous cell carcinomas of the colon and rectum are extremely rare, with an incidence of less than 1% of colorectal malignancies. Our aim in this study was to evaluate patient characteristics, treatment strategy, and postoperative follow-up of patients with colorectal squamous cell carcinoma.


METHODS
We reviewed our prospectively maintained colorectal cancer database for all patients who were diagnosed with colorectal squamous cell carcinoma between January 1990 and April 2009.


RESULTS
Out of 5149 patients with colorectal malignancy, 11 patients (0.2%) met the study criteria. Median age at the time of diagnosis was 64. Median BMI was 28 kg/m2. The tumors were localized in the rectum (n = 8), right colon (n = 2), and sigmoid colon (n = 1). The pathologic stages of these tumors were I (n = 1), II (n = 4), III (n = 3), and IV (n = 3). Operations performed were abdominoperineal resection (n = 4), right colectomy (n = 2), total colectomy (n = 1), low anterior resection (n = 1), local excision (n = 1), sigmoidectomy (n=1) and end colostomy creation (n = 1). One patient received intraoperative radiotherapy. Postoperative chemotherapy was given to eight patients, and three patients received postoperative radiation therapy. Median follow-up after diagnosis was 42 months (12-96). Three patients developed recurrence after potentially curative surgery. Five patients died from metastatic disease during follow-up.


CONCLUSIONS
Squamous colorectal cancer can be detected in any part of the colon, generally presents at a later stage, and is associated with a poor prognosis. Surgery is the mainstay of treatment. Various adjuvant chemoradiation treatments appear not to influence the outcome. Further cases need to be analyzed in order to find more effective treatment regimens.
Department of Colorectal Surgery, Digestive Disease Institute, 9500 Euclid Ave. A30, Cleveland, OH, 44195, USA, ozunerg@ccf.org.
Gokhan
G
Ozuner
Erman
E
Aytac
Emre
E
Gorgun
Ana
A
Bennett
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies