Published online Jan 14, 2024. doi: 10.3748/wjg.v30.i2.158
Peer-review started: October 25, 2023
First decision: November 12, 2023
Revised: November 23, 2023
Accepted: December 14, 2023
Article in press: December 14, 2023
Published online: January 14, 2024
Processing time: 78 Days and 15.4 Hours
Tumor budding (TB) has emerged as a promising independent prognostic biomarker in colorectal cancer (CRC). The prognostic role of TB has been exten
To analyze the relationship between TB categories and clinicopathological characteristics and assess their prognostic value in stage III-IV CRC to further refine the prognostic risk stratification of stage III-IV CRC.
The clinical data of 547 CRC patients were collected for this retrospective study. Infiltration at the front edge of the tumor buds was counted according to the 2016 International Tumor Budding Consensus Conference guidelines.
Multivariate Cox proportional hazards regression analysis demonstrated that chemotherapy (P = 0.004), clinical stage IV (P < 0.001), ≥ 4 regional lymph node metastases (P = 0.004), left-sided colonic cancer (P = 0.040), and Bd 2-3 (P = 0.002) were independent prognostic factors in patients with stage III-IV CRC. Moreover, the density of tumor infiltrating lymphocytes was higher in Bd 1 than in Bd 2-3, both in the tumor stroma and its invasive margin.
TB has an independent predictive prognostic value in patients with stage III-IV CRC. It is recommended to complete the TB report of stage III-IV CRC cases in the standardized pathological report to further refine risk stratification.
Core Tip: This study included 547 colorectal cancer (CRC) patients. Tumor budding (TB) was evaluated independently by two pathologists and re-evaluated by a third pathologist when the results were inconsistent, ensuring a high level of reliability. The 2016 International Tumor Budding Consensus Conference recommendations were followed to evaluate TB in patients with stage III-IV CRC, thereby investigating its impact on patient prognosis. TB has predictive prognostic value for progression-free survival and overall survival in patients with stage III-IV CRC. It is recommended to complete the TB report of stage III-IV CRC cases in the standardized pathological report to further refine risk stratification.