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Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
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Prognostic Ability of Tumor Budding Outperforms Poorly Differentiated Clusters in Gastric Cancer
Luca Szalai1,2, Ákos Jakab1, Ildikó Kocsmár1,3
1Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői Str. 93, H-1091 Budapest, Hungary.
Cancers
|October 14, 2022
Summary
Tumor budding (TB) is a significant independent prognostic factor for survival in gastric cancer, particularly in intestinal-type adenocarcinomas. High TB predicts poorer overall survival and increased lymph node metastasis.
Area of Science:
- Oncology
- Pathology
- Gastroenterology
Background:
- The prognostic significance of tumor budding (TB) and poorly differentiated clusters (PDCs) in gastric cancer (GAC) remains understudied and controversial.
- Existing data on TB and PDCs in GAC are limited, necessitating further investigation into their predictive value.
Purpose of the Study:
- To evaluate the prognostic value of tumor budding (TB) and poorly differentiated clusters (PDCs) in surgically resected gastric cancer (GAC).
- To determine the association of TB and PDCs with clinicopathological features and patient survival in GAC.
Main Methods:
- Retrospective analysis of 290 surgically resected GAC cases.
- Evaluation of TB and PDCs using International Tumor Budding Consensus Conference (ITBCC) criteria and a grading scale adapted from colorectal cancer.
- Multivariable survival analyses to assess independent prognostic roles.
Main Results:
- High TB/PDC was associated with diffuse-type morphology, higher pT status, incomplete resection, poor differentiation, and invasion.
- High TB independently predicted poorer overall survival in the total cohort and intestinal-type GAC.
- High TB was an independent predictor of lymph node metastasis in both groups.
- PDCs showed no significant association with lymph node metastasis, tumor stage, or survival.
Conclusions:
- Tumor budding is an independent prognostic factor for survival in gastric cancer, especially in intestinal-type adenocarcinomas.
- Tumor budding is a valuable predictor of lymph node metastasis in gastric cancer.
- Poorly differentiated clusters do not appear to have significant prognostic value in gastric cancer.
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