Tumour budding in preoperative biopsy specimens is a useful prognostic index for identifying high-risk patients in early-stage (pN0) colon cancer
Tumour budding
colon cancer
preoperative biopsy
early-stage (pN0)
Journal
Turkish journal of medical sciences
ISSN: 1303-6165
Titre abrégé: Turk J Med Sci
Pays: Turkey
ID NLM: 9441758
Informations de publication
Date de publication:
09 04 2020
09 04 2020
Historique:
received:
18
03
2019
accepted:
02
02
2020
entrez:
4
2
2020
pubmed:
6
2
2020
medline:
7
2
2021
Statut:
epublish
Résumé
Tumour budding (BD) is considered a valuable prognostic factor in colon cancer (CC), but its use in daily practice is uncertain. We investigated the prognostic effect of BD using preoperativebiopsy specimens in a fairly homogeneous population. Eighty-two (pN0) CC patients who underwent surgery after preoperativebiopsy between 1997 and 2013 were included in the study. Model A (using the ‘deeply invasive blocks & hot-spot area & invasive margin) and method 1 (using the ‘20× objective & immunohistochemistry staining & quantitive counting’) were used as standard methods. High BD was significantly associated with poor prognostic factors (lymphatic invasion [P = 0.008], perineural invasion [P = 0.041], advanced pT [P = 0.015], invasive margin [P = 0.008], and margin involvement [P = 0.019]). Moreover, correlations between different BD estimates (r = 0.613–0.696), reproducibility of study (Κappa = 0.68–0.73), and usefulnessofcut-off value (area of under ROC = 0.746 [0.663–0.829]) were well. In univariate analysis, 5-year survival was poor in patients with high BD (relaps-free survival [RFS]: 71 %, P < 0.001; overall survival [OS]: 73 %, P = 0.004, local recurrence [LR]: 18 %, P = 0.032). Multivariate analyses confirmed that high BD is an independent worse survival parameter for RFS (Hazard ratio [HR]: 1.53 [1.14–2.80], P = 0.015), OS (HR: 1.44 [1.17–2.75], P = 0.032, and LR (HR: 1.59 [1.05–2.76], P = 0.045). Our data show that BD provides valuable prognostic information for early-stage (pN0) CC in preoperativebiopsy specimens and that adding BD to current risk classification may contribute to better patient selection.
Sections du résumé
Background/aim
Tumour budding (BD) is considered a valuable prognostic factor in colon cancer (CC), but its use in daily practice is uncertain. We investigated the prognostic effect of BD using preoperativebiopsy specimens in a fairly homogeneous population.
Materials and methods
Eighty-two (pN0) CC patients who underwent surgery after preoperativebiopsy between 1997 and 2013 were included in the study. Model A (using the ‘deeply invasive blocks & hot-spot area & invasive margin) and method 1 (using the ‘20× objective & immunohistochemistry staining & quantitive counting’) were used as standard methods.
Results
High BD was significantly associated with poor prognostic factors (lymphatic invasion [P = 0.008], perineural invasion [P = 0.041], advanced pT [P = 0.015], invasive margin [P = 0.008], and margin involvement [P = 0.019]). Moreover, correlations between different BD estimates (r = 0.613–0.696), reproducibility of study (Κappa = 0.68–0.73), and usefulnessofcut-off value (area of under ROC = 0.746 [0.663–0.829]) were well. In univariate analysis, 5-year survival was poor in patients with high BD (relaps-free survival [RFS]: 71 %, P < 0.001; overall survival [OS]: 73 %, P = 0.004, local recurrence [LR]: 18 %, P = 0.032). Multivariate analyses confirmed that high BD is an independent worse survival parameter for RFS (Hazard ratio [HR]: 1.53 [1.14–2.80], P = 0.015), OS (HR: 1.44 [1.17–2.75], P = 0.032, and LR (HR: 1.59 [1.05–2.76], P = 0.045).
Conclusion
Our data show that BD provides valuable prognostic information for early-stage (pN0) CC in preoperativebiopsy specimens and that adding BD to current risk classification may contribute to better patient selection.
Identifiants
pubmed: 32011836
doi: 10.3906/sag-1903-142
pmc: PMC7164766
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
375-385Informations de copyright
This work is licensed under a Creative Commons Attribution 4.0 International License.
Déclaration de conflit d'intérêts
The authors do not report any conflict of interest.
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