scholarly journals Tumor Budding beim kolorektalen Karzinom – Informationen zur klinischen Anwendung und Anleitung zur praktischen Bestimmung

Der Pathologe ◽  
2021 ◽  
Author(s):  
Felix Müller ◽  
Alessandro Lugli ◽  
Heather Dawson
Keyword(s):  
Cancer Control ◽  
Consensus Conference ◽  
Tumor Budding ◽  
Klinischer Verlauf

Zusammenfassung Hintergrund Bei einzelnen Patienten mit kolorektalen Karzinomen (CRC) zeigt sich ein schlechter klinischer Verlauf innerhalb desselben UICC-Stadiums (Union for International Cancer Control). Die Identifizierung von zusätzlichen Risikofaktoren ist daher notwendig, um eine optimale Therapieplanung zu erreichen. Fragestellung In welchen Situationen kann Tumor Budding die klinische Therapieentscheidung beeinflussen und wie sollte die standardisierte Auswertung erfolgen? Material und Methode Aktuelle Publikationen zum Thema Tumor Budding werden mit Fokus auf die praktische Anwendung und potenzielle Problemfälle in der Bestimmung des Tumor Buddings erläutert. Ergebnisse Tumor Budding ist ein signifikanter Risikofaktor für einen schlechteren Verlauf des CRC und kann bei pT1-Karzinomen sowie Stadium-II-Karzinomen die Behandlung beeinflussen. Die Auswertung wurde durch die International Tumor Budding Consensus Conference (ITBCC) 2016 standardisiert und ist in der Praxis anwendbar. Schwierigkeiten in der Anwendung können durch die Kenntnis von potenziellen Problemfällen vermieden werden.

scholarly journals The Relationship Between Tumor Budding, Tumor Microenvironment, and Survival in Patients with Primary Operable Colorectal Cancer

2019 ◽  
Vol 26 (13) ◽  
pp. 4397-4404 ◽  
Author(s):  
Hester C. van Wyk ◽  
Antonia Roseweir ◽  
Peter Alexander ◽  
James H. Park ◽  
Paul G. Horgan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Tumor Microenvironment ◽  
Evaluation Method ◽  
Venous Invasion ◽  
Staging System ◽  
Consensus Conference ◽  
Tumor Budding ◽  
Inflammatory Cell Infiltrate ◽  
Cancer Specific Survival ◽  
The Relationship

Abstract Background Tumor budding is an independent prognostic factor in colorectal cancer (CRC) and has recently been well-defined by the International Tumour Budding Consensus Conference (ITBCC). Objective The aim of the present study was to use the ITBCC budding evaluation method to examine the relationship between tumor budding, tumor factors, tumor microenvironment, and survival in patients with primary operable CRC. Methods Hematoxylin and eosin-stained slides of 952 CRC patients diagnosed between 1997 and 2007 were evaluated for tumor budding according to the ITBCC criteria. The tumor microenvironment was evaluated using tumor stroma percentage (TSP) and Klintrup–Makinen (KM) grade to assess the tumor inflammatory cell infiltrate. Results High budding (n = 268, 28%) was significantly associated with TNM stage (p < 0.001), competent mismatch repair (MMR; p < 0.05), venous invasion (p < 0.001), weak KM grade (p < 0.001), high TSP (p < 0.001), and reduced cancer-specific survival (CSS) (hazard ratio 8.68, 95% confidence interval 6.30–11.97; p < 0.001). Tumor budding effectively stratifies CSS stage T1 through to T4 (all p < 0.05) independent of associated factors. Conclusions Tumor budding effectively stratifies patients’ survival in primary operable CRC independent of other phenotypic features. In particular, the combination of T stage and budding should form the basis of a new staging system for primary operable CRC.

scholarly journals Validation of the International Tumor Budding Consensus Conference 2016 recommendations on tumor budding in stage I-IV colorectal cancer

2019 ◽  
Vol 85 ◽  
pp. 145-151 ◽  
Author(s):  
Heather Dawson ◽  
Francesca Galuppini ◽  
Peter Träger ◽  
Martin D. Berger ◽  
Peter Studer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Consensus Conference ◽  
Stage I ◽  
Tumor Budding

scholarly journals Prognostic Impact of Tumor Budding on Moroccan Colon Cancer Patients

2021 ◽  
Author(s):  
Fatima El agy ◽  
Sanae El bardai ◽  
Laila Bouguenouch ◽  
Nada Lahmidani ◽  
Mohammed El abkari ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Colon Adenocarcinoma ◽  
Distant Metastases ◽  
Consensus Conference ◽  
Clinicopathological Features ◽  
Molecular Signature ◽  
Tumor Budding ◽  
Prognostic Impact ◽  
Kras Mutations

Abstract Background: Tumor budding is now emerging as one of the robust and promising histological factors that play an important role in colon cancer. In this study, we aimed to investigate the association between tumor budding and tumor clinicopathological factors, tumor molecular signature, and patient survival for the first time in the Moroccan population. Methods: We collected data of 100 patients with operated colon adenocarcinoma. Tumor budding was assessed on HES slides, according to the International Tumor Budding Consensus Conference 2016 recommendations. The expression of MMR proteins was performed by Immunohistochemistry. KRAS and NRAS mutations testing was performed by Sanger sequencing and pyrosequençing. Results: High tumor budding grade (BUD 3) was found to be significantly associated with adverse clinicopathological features including older age (P=0.03), presence of perineural invasion (P=0.02), presence of vascular invasion (P=0.05), distant metastases (P˂0.001), advanced TNM stage (P=0.001), the occurrence of relapse (P=0.04), and the high number of deceased cases (P=0.02). Interestingly, we found that tumors with high budding were more likely to be microsatellite stable (MSS) (P=0.005) and harbor more KRAS mutations (P=0.02). In all stages, High tumor budding was correlated with poorer overall survival (P=0.04) and decreased relapse-free survival with a difference close to significance ((P=0.09). we concluded that high tumor budding was strongly associated with unfavorable clinicopathological features and special molecular biomarkers and effectively affects the overall survival of CC patients. Conclusions: Based on these findings and the ITBCC group recommendations, tumor budding should be taken into account along with other clinicopathologic factors in the risk assessment of colorectal cancer.

scholarly journals Tumor Budding in Colorectal Carcinoma: Translating a Morphologic Score Into Clinically Meaningful Results

2018 ◽  
Vol 142 (8) ◽  
pp. 952-957 ◽  
Author(s):  
Soo-Jin Cho ◽  
Sanjay Kakar
Keyword(s):  
Prognostic Factor ◽  
Colorectal Carcinoma ◽  
English Language ◽  
Lymph Node Involvement ◽  
Consensus Conference ◽  
Tumor Budding ◽  
Independent Prognostic Marker ◽  
Routine Basis ◽  
Node Involvement ◽  
Pathology Reports

Context.— Tumor budding has received increasing recognition as an important independent prognostic factor in colorectal carcinoma. Prominent tumor budding in adenocarcinoma arising in a polyp has been shown to be a risk factor for lymph node involvement. The variability in methods used for evaluating tumor budding in different studies and lack of standardized guidelines have impeded routine inclusion of tumor budding in pathology reports. This changed last year with consensus guidelines based on the International Tumor Budding Consensus Conference (ITBCC). These guidelines have been included in the recent College of American Pathologists (CAPs) Colorectal Cancer Protocol. The consensus methodology will allow uniform reporting of this finding, but challenges in interpretation in the setting of intense inflammation, fibrosis, or gland fragmentation need to be addressed in future guidelines. Objective.— To provide a brief overview of the known clinical significance of tumor budding in colorectal carcinoma and discuss the practical aspects of its implementation on a routine basis. Data Sources.— English-language pathology literature. Conclusions.— Tumor budding has been shown to be an independent prognostic marker in colorectal carcinomas and the routine reporting of tumor buds is now advocated by using the approach outlined by the ITBCC guidelines. Tumor budding is included in the CAP protocol as a recommended element. Presence of prominent tumor budding in an adenocarcinoma in a polyp may have implications for management, such as additional resection, while it serves as a prognostic factor in other settings.

Tumor budding is a strong predictor of disease-free survival in stage II colorectal cancer: Validation study based on the International Tumor Budding Consensus Conference (ITBCC) recommendations.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 594-594 ◽  
Author(s):  
Heather Dawson ◽  
Naziheh Assarzadegan ◽  
Robert Riddell ◽  
Richard Kirsch ◽  
Annika Blank ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Tumor Cells ◽  
Disease Free Survival ◽  
The United States ◽  
Consensus Conference ◽  
Stage Ii ◽  
Tumor Budding ◽  
Free Survival ◽  
Staging Systems ◽  
Disease Free

594 Background: Tumor budding, defined as single tumor cells or small clusters of four or less tumor cells at the invasive front, has been shown to be a strong and independent prognostic factor in colorectal cancer (CRC). However, widespread reporting of tumor budding has been held back largely due to a lack of consensus on scoring methods. 23 experts from the United States, Canada, Japan and Europe participated at the International Tumor Budding Consensus Conference (ITBCC), held in April 2016 in Bern, Switzerland, and agreed on a set of recommendations for assessing and reporting tumor budding in CRC. The aim of this study was to validate the method proposed by ITBCC in the clinically relevant scenario of Stage II CRC. Methods: In 151 Stage II CRC patients, tumor budding was assessed on scanned H&E-stained slides in a single hot spot measuring 0.785mm2. Cutoffs as defined by ITBCC were used: Low (Bd1): 0-4 buds, intermediate (Bd2): 5-9 buds, high (Bd3): ≥ 10 buds. Statistical analysis for associations with clinicopathological features, disease free survival (DFS) and overall survival (OS) was performed. Results: The average number of buds/hotspot was 6.8 (median 5.0). 43.1% of cases were Bd1, 27.2% Bd2 and 29.8% Bd3. Tumor budding as a continuous variable was associated with extramural venous invasion (EMVI) (p = 0.05). Tumor budding was associated with poorer OS in univariate analysis (p = 0.0386, HR 1.048, 95%CI 1.002-1.095). For 3- and 5- year DFS, Bd3 was associated with significantly worse survival in comparison with Bd1/2 (p = 0.0031 and p = 0.0025, respectively). In multivariate analysis adjusting for pT, tumor grade and EMVI, tumor budding retained its adverse prognostic effect for DFS (p = 0.006, HR 3.293, 95%CI 1.66-6.53). Conclusions: This study provides promising data on tumor budding assessed by the ITBCC method in the Stage II scenario. Especially Bd3 shows a detrimental adverse impact on DFS in comparison to Bd1/Bd2. Based on the ITBCC, tumor budding has the potential to strongly affect the management of Stage II CRC patients and should be therefore included in reporting guidelines and staging systems in CRC.

scholarly journals Interobserver Variability in the Assessment of Tumor Budding in pT 3/4 Colon Cancer: Improvement by Supporting Immunohistochemistry?

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 730
Author(s):  
Benedikt Martin ◽  
Patrick Mayr ◽  
Regina Ihringer ◽  
Eva-Maria Schäfer ◽  
Elżbieta Jakubowicz ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Interobserver Variability ◽  
Prognostic Significance ◽  
Distant Metastases ◽  
Consensus Conference ◽  
Tumor Budding ◽  
Cancer Specific Survival ◽  
Cytokeratin Immunohistochemistry ◽  
Different Levels ◽  
Level Of Agreement

The prognostic significance of tumor budding in colon cancer is unequivocally documented, and the recommendations of the International Tumor Budding Consensus Conference (ITBCC) are currently the accepted basis for its assessment. Up to now, it is unknown whether the general use of a supporting cytokeratin immunohistochemistry can improve the interobserver variability and prognostic significance. Six investigators with different levels of experience reassessed 229 cases of colon carcinoma (pT3/4, N+/−, M0) with a supporting cytokeratin immunohistochemistry. The results were compared to previous assessments, which have been performed only on H & E. Bd3 was significantly associated with the occurrence of distant metastases according to the assessments of three out of six investigators (p < 0.05). Only one single investigator reached significant results concerning the cancer specific survival (p = 0.01). The pairwise kappa values range between a poor and moderate level of agreement (range 0.17–0.45; median 0.21). In conclusion, the results show no superiority of the use of an additional cytokeratin immunohistochemistry compared to the conventional analysis on sole H & E slides. Therefore, the general supporting use of a cytokeratin immunohistochemical staining seems to be inadvisable in colon cancer in consideration of necessary resources and costs.

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