A criticism of the study is the fact that allocation of the patients was not random, which may present potential biases. A large-scale randomized trial for comparison of minilaparotomy and laparoscopic rectal cancer surgeries is needed. Careful patient selection is also crucial. Acknowledgements Disclosure: The authors have no conflicts of interest.
Signet Inhibitors,research,lifescience,medical ring cell carcinoma (SRCC) of colon and mucinous adenocarcinoma (MCC) of colon are rare histologic subtypes of adenocarcinoma of colon accounting for approximately 0.5-1 percent and 15-20 percent of all adenocarcinomas of colon respectively (1). Signet ring cell cancers are most Sotrastaurin commonly seen

in the stomach (95%) and occasionally found in colon, rectum, ovary, peritoneum and gallbladder (2). It is characterized by specific morphologic appearance of abundant intracytoplasmic mucin

pushing nucleus to the periphery giving it a signet ring cell appearance. SRCC is similar to MCC in possessing abundant mucin. The World Health Organization classification of tumors has a specific criteria for Inhibitors,research,lifescience,medical diagnosis of these sub types–SRCC is defined as presence of more than 50 percent of signet cells and MCC is defined as presence of more than 50 percent of mucin component (3). Previous studies Inhibitors,research,lifescience,medical have shown that SRCC often presents at young age, in advanced stage, with more peritoneal involvement and has poor prognosis (4,5). However, majority of these studies are single institution based including Inhibitors,research,lifescience,medical small number of patients. Because of the rarity of the disease, clinico-pathological features and prognosis has not been well understood and there have been very few studies comparing SRCC with MCC and non-mucinous adenocarcinoma (NMCC) of colon. Hence we conducted

a retrospective study on the large nationwide veteran population to understand the clinicopathological features and the survival outcomes of SRCC, MCC and NMCC. Methods Data source The study was approved by the local Institutional Review Board. Data for this study was obtained by accessing the Veteran’s Affairs Central Cancer Registry (VACCR) database. VACCR is a population-based registry sponsored by Inhibitors,research,lifescience,medical the Veteran’s Affairs Healthcare system that contains information from patients diagnosed and/or treated at all 143 Veterans Affairs (VA) medical centers. Each case report adheres to the standards established Calpain by the American College of Surgeons’ Commission on Cancer Facility Oncology Registry Data Standards for data collection and definitions and must pass North American Association of Central Cancer Registry electronic quality assurance edits before being merged/consolidated into the master database. Study population A total of 36,260 Veteran’s diagnosed with colon cancer between January 1995 and December 2008 were identified from the VACCR database. Of which 26,669 were NMCC patients, 2,443 were MCC patients, and 206 were SRCC patients and 6,942 were other histology’s.