Tumour Budding and Survival in Stage II Colorectal Cancer: a Systematic Review and Pooled Analysis
F Petrelli1, E Pezzica, M Cabiddu
1Department of Oncology, Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy, faupe@libero.it.
Journal of Gastrointestinal Cancer
|May 22, 2015
Summary
Tumour budding, a feature in colorectal cancer (CRC), significantly worsens survival in stage II patients. High-grade budding indicates a higher risk of death, potentially guiding adjuvant chemotherapy decisions.
Area of Science:
- Oncology
- Pathology
- Cancer Research
Background:
- Tumour budding, characterized by small malignant cell clusters at the invasive tumor edge, is a recognized negative prognostic factor in colorectal cancer (CRC).
- It is frequently associated with adverse pathological features and poorer patient outcomes.
- The prognostic significance of tumour budding in stage II CRC warrants further investigation.
Purpose of the Study:
- To conduct a meta-analysis evaluating the association between tumour budding and survival in stage II colorectal cancer (CRC) patients.
- To quantify the impact of tumour budding on overall survival (OS) in this patient cohort.
Main Methods:
- A systematic literature search was performed across PubMed, EMBASE, Web of Science, and SCOPUS.
- Data from 12 studies including 1652 patients were analyzed to calculate odds ratios (ORs) for death and hazard ratios (HRs) for survival.
- The Mantel-Haenszel random effect model was employed for data pooling.
Main Results:
- High-grade tumour budding was significantly associated with worse 5-year overall survival (OS) in stage II CRC patients (OR for death: 6.25, P < 0.00001).
- The absolute difference in 5-year OS was -25% for patients with high-grade budding.
- High-grade budding increased the risk of death (HR: 3.68, P < 0.00001).
Conclusions:
- Tumour budding is a significant predictor of worse survival in stage II colorectal cancer (CRC).
- This association is particularly pronounced in pT3N0M0 patients.
- Tumour budding may aid in identifying high-risk, node-negative CRC patients who could benefit from adjuvant chemotherapy.
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