Tumour Budding Is a Useful Predictor to Identify High-Risk Stage II Colon Cancer Patients After Curative Surgery

Area of Science:

• Oncology
• Cancer Research
• Pathology

Background:

• Tumor budding (TB) is recognized as a prognostic indicator in colon cancer (CC).
• Standardized methods for TB assessment are crucial for reliable clinical application.
• Existing literature shows uncertainties regarding the daily use and methodological validation of TB in CC prognosis.

Purpose of the Study:

• To methodologically examine the role of tumor budding (TB) in predicting survival outcomes in colon cancer (CC).
• To identify and validate an optimal evaluation method for TB assessment in CC.
• To confirm TB as an independent prognostic factor in stage II CC.

Main Methods:

• Retrospective analysis of colon cancer (CC) patients with long-term follow-up (up to 15 years).
• Comparative evaluation of different methodological approaches for calculating tumor budding (TB).
• Univariate and multivariate survival analyses (Recurrence-Free Survival [RFS] and Overall Survival [OS]) using validated TB assessment methods.

Main Results:

• Method-1 demonstrated superior correlation with prognostic factors (e.g., venous invasion, advanced pT, nodal involvement) and good repeatability (Kappa = 0.53-0.75).
• High TB, as determined by Method-1, was significantly associated with worse RFS (81%) and OS (84%) in univariate analysis.
• Multivariate analysis confirmed high TB as an independent poor prognostic parameter for RFS (p=0.002, HR: 1.42) and OS (p=0.014, HR: 1.38) in stage II CC.

Conclusions:

• The standardized method for calculating tumor budding (TB) is a highly valuable prognostic parameter in stage II colon cancer (CC).
• TB assessment contributes to identifying patients with a poor prognosis, enabling more targeted management strategies.
• This validated methodology enhances the clinical utility of TB in routine colon cancer diagnostics.