Prognostic and Predictive Value of Tumor Budding in Colorectal Cancer

Area of Science:

• Oncology
• Pathology
• Cancer Research

Background:

• Tumor budding (TB) is recognized as an adverse prognostic factor in colorectal cancer (CRC).
• Standardized assessment methods have increased TB reporting, yet clinical value remains debated.
• Uncertainty exists regarding TB's impact on treatment response.

Purpose of the Study:

• To validate the prognostic significance of TB in stage II CRC.
• To establish optimal risk group thresholds for TB.
• To investigate TB's influence on chemotherapy responsiveness.

Main Methods:

• Analysis of 1575 colorectal cancer patient samples from the QUASAR trial.
• Assessment of tumor budding (TB) in tissue sections.
• Log-rank analyses to evaluate recurrence and mortality based on TB levels.

Main Results:

• Optimal threshold for high-grade TB (HGTB) identified as ≥10 buds/mm².
• HGTB tumors showed significantly higher 10-year recurrence (36% vs. 22%) and mortality (50% vs. 37%).
• Prognostic significance of TB remained robust, independent of other pathological factors.

Conclusions:

• Tumor budding is a potent independent predictor of CRC recurrence.
• Chemotherapy efficacy is comparable for patients with high and low TB counts.
• Absolute benefits of chemotherapy are amplified in patients with higher TB counts.