Tumor budding is a strong and reproducible prognostic marker in T3N0 colorectal cancer.

Hdl Handle:
http://hdl.handle.net/10147/207529
Title:
Tumor budding is a strong and reproducible prognostic marker in T3N0 colorectal cancer.
Authors:
Wang, Lai Mun; Kevans, David; Mulcahy, Hugh; O'Sullivan, Jacintha; Fennelly, David; Hyland, John; O'Donoghue, Diarmuid; Sheahan, Kieran
Affiliation:
Department of Histopathology & Centre for Colorectal Disease, St Vincent's, University Hospital, Dublin, Ireland.
Citation:
Am J Surg Pathol. 2009 Jan;33(1):134-41.
Journal:
The American journal of surgical pathology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207529
DOI:
10.1097/PAS.0b013e318184cd55
PubMed ID:
18971777
Abstract:
BACKGROUND: Tumor budding along the advancing front of colorectal adenocarcinoma is an early event in the metastatic process. A reproducible, prognostic budding scoring system based on outcomes in early stage colorectal cancer has not been established. DESIGN: One hundred twenty-eight T3N0M0 colorectal carcinoma patients with known outcome were identified. Tumor budding was defined as isolated tumor cells or clusters of <5 cells at the invasive tumor front. Tumor bud counts were generated in 5 regions at 200x by 2 pathologists (conventional bud count method). The median bud count per case was used to divide cases into low (median=0) and high budding (median > or =1) groups. Forty cases were reevaluated to assess reproducibility using the conventional and a novel rapid bud count method. RESULTS: Fifty-seven (45%) carcinomas had high and 71 (55%) had low budding scores. High budding was associated with an infiltrative growth pattern (P<0.0001) and lymphovascular invasion (P=0.005). Five-year cancer-specific survival was significantly poorer in high compared with low budding groups: 63% versus 91%, respectively, P<0.0001. Multivariate analysis demonstrated tumor budding to be independently prognostic (hazard ratio=4.76, P<0.001). Interobserver agreement was at least equivalent comparing the conventional to the rapid bud count methods: 87.5% agreement (kappa=0.75) versus 92.5% agreement (kappa=0.85), respectively. CONCLUSIONS: Tumor budding is a strong, reproducible, and independent prognostic marker of outcome that is easily assessed on hematoxylin and eosin slides. This may be useful for identifying the subset of T3N0M0 patients at high risk of recurrence who may benefit from adjuvant therapy.
Language:
eng
MeSH:
Adenocarcinoma/mortality/*pathology; Adult; Aged; Aged, 80 and over; Colorectal Neoplasms/mortality/*pathology; Cytological Techniques/*methods/statistics & numerical data; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasm Staging; Observer Variation; Prognosis
ISSN:
1532-0979 (Electronic); 0147-5185 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorWang, Lai Munen_GB
dc.contributor.authorKevans, Daviden_GB
dc.contributor.authorMulcahy, Hughen_GB
dc.contributor.authorO'Sullivan, Jacinthaen_GB
dc.contributor.authorFennelly, Daviden_GB
dc.contributor.authorHyland, Johnen_GB
dc.contributor.authorO'Donoghue, Diarmuiden_GB
dc.contributor.authorSheahan, Kieranen_GB
dc.date.accessioned2012-02-01T10:30:24Z-
dc.date.available2012-02-01T10:30:24Z-
dc.date.issued2012-02-01T10:30:24Z-
dc.identifier.citationAm J Surg Pathol. 2009 Jan;33(1):134-41.en_GB
dc.identifier.issn1532-0979 (Electronic)en_GB
dc.identifier.issn0147-5185 (Linking)en_GB
dc.identifier.pmid18971777en_GB
dc.identifier.doi10.1097/PAS.0b013e318184cd55en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207529-
dc.description.abstractBACKGROUND: Tumor budding along the advancing front of colorectal adenocarcinoma is an early event in the metastatic process. A reproducible, prognostic budding scoring system based on outcomes in early stage colorectal cancer has not been established. DESIGN: One hundred twenty-eight T3N0M0 colorectal carcinoma patients with known outcome were identified. Tumor budding was defined as isolated tumor cells or clusters of <5 cells at the invasive tumor front. Tumor bud counts were generated in 5 regions at 200x by 2 pathologists (conventional bud count method). The median bud count per case was used to divide cases into low (median=0) and high budding (median > or =1) groups. Forty cases were reevaluated to assess reproducibility using the conventional and a novel rapid bud count method. RESULTS: Fifty-seven (45%) carcinomas had high and 71 (55%) had low budding scores. High budding was associated with an infiltrative growth pattern (P<0.0001) and lymphovascular invasion (P=0.005). Five-year cancer-specific survival was significantly poorer in high compared with low budding groups: 63% versus 91%, respectively, P<0.0001. Multivariate analysis demonstrated tumor budding to be independently prognostic (hazard ratio=4.76, P<0.001). Interobserver agreement was at least equivalent comparing the conventional to the rapid bud count methods: 87.5% agreement (kappa=0.75) versus 92.5% agreement (kappa=0.85), respectively. CONCLUSIONS: Tumor budding is a strong, reproducible, and independent prognostic marker of outcome that is easily assessed on hematoxylin and eosin slides. This may be useful for identifying the subset of T3N0M0 patients at high risk of recurrence who may benefit from adjuvant therapy.en_GB
dc.language.isoengen_GB
dc.subject.meshAdenocarcinoma/mortality/*pathologyen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshColorectal Neoplasms/mortality/*pathologyen_GB
dc.subject.meshCytological Techniques/*methods/statistics & numerical dataen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshKaplan-Meier Estimateen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshNeoplasm Stagingen_GB
dc.subject.meshObserver Variationen_GB
dc.subject.meshPrognosisen_GB
dc.titleTumor budding is a strong and reproducible prognostic marker in T3N0 colorectal cancer.en_GB
dc.contributor.departmentDepartment of Histopathology & Centre for Colorectal Disease, St Vincent's, University Hospital, Dublin, Ireland.en_GB
dc.identifier.journalThe American journal of surgical pathologyen_GB
dc.description.provinceLeinster-

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