Luo YH, Yan ZC, Liu JY, Li XY, Yang M, Fan J, Huang B, Ma CG, Chang XN, Nie X. Association of tumor budding with clinicopathological features and prognostic value in stage III-IV colorectal cancer. World J Gastroenterol 2024; 30(2): 158-169 [PMID: 38312121 DOI: 10.3748/wjg.v30.i2.158]
Corresponding Author of This Article
Xiu Nie, MD, Professor, Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China. niexiuyishi@126.com
Research Domain of This Article
Pathology
Article-Type of This Article
Retrospective Study
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Luo YH, Yan ZC, Liu JY, Li XY, Yang M, Fan J, Huang B, Ma CG, Chang XN, Nie X. Association of tumor budding with clinicopathological features and prognostic value in stage III-IV colorectal cancer. World J Gastroenterol 2024; 30(2): 158-169 [PMID: 38312121 DOI: 10.3748/wjg.v30.i2.158]
World J Gastroenterol. Jan 14, 2024; 30(2): 158-169 Published online Jan 14, 2024. doi: 10.3748/wjg.v30.i2.158
Association of tumor budding with clinicopathological features and prognostic value in stage III-IV colorectal cancer
Yue-Hao Luo, Zhe-Cheng Yan, Jia-Ying Liu, Xin-Yi Li, Ming Yang, Jun Fan, Bo Huang, Cheng-Gong Ma, Xiao-Na Chang, Xiu Nie
Yue-Hao Luo, Zhe-Cheng Yan, Jia-Ying Liu, Xin-Yi Li, Ming Yang, Jun Fan, Bo Huang, Cheng-Gong Ma, Xiao-Na Chang, Xiu Nie, Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Co-first authors: Yue-Hao Luo and Zhe-Cheng Yan.
Co-corresponding authors: Xiao-Na Chang and Xiu Nie.
Author contributions: Luo YH and Yan ZC contributed equally to this work; Luo YH, Yan ZC, Liu JY, Li XY, Yang M, and Fan J designed the research study; Luo YH, Huang B, and Ma CG performed the research; Luo YH, Chang XN, and Niu X analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Supported byNational Key R&D Program of China, No. 2022YFF1203300.
Institutional review board statement: This study was approved by the review committee of the affiliated institution of Tongji Medical College of Huazhong University of Science and Technology (2018-S377).
Informed consent statement: Consent was obtained from all patients participating in the study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Corresponding author: Xiu Nie, MD, Professor, Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China. niexiuyishi@126.com
Received: October 25, 2023 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
Abstract
BACKGROUND
Tumor budding (TB) has emerged as a promising independent prognostic biomarker in colorectal cancer (CRC). The prognostic role of TB has been extensively studied and currently affects clinical decision making in patients with stage I and II CRC. However, existing prognostic studies on TB in stage III CRC have been confined to small retrospective cohort studies. Consequently, this study investigated the correlation among TB categories, clinicopathological features, and prognosis in stage III-IV CRC to further enhance the precision and individualization of treatment through refined prognostic risk stratification.
AIM
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.
METHODS
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.
RESULTS
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.
CONCLUSION
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.
