Tumor budding is a strong and reproducible prognostic marker in T3N0 colorectal cancer.
Authors
Wang, Lai MunKevans, 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.Issue Date
2012-02-01T10:30:24ZMeSH
Adenocarcinoma/mortality/*pathologyAdult
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
Metadata
Show full item recordCitation
Am J Surg Pathol. 2009 Jan;33(1):134-41.Journal
The American journal of surgical pathologyDOI
10.1097/PAS.0b013e318184cd55PubMed ID
18971777Abstract
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
engISSN
1532-0979 (Electronic)0147-5185 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1097/PAS.0b013e318184cd55
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