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Extended tumor area-based stratification score combining tumor budding and stroma identifies a high-risk, immune-depleted group in localized microsatellite-stable colon cancer patients

  • 0Department of Pathology. Hospital Clínico Universitario of Valencia. Biomedical Research Institute INCLIVA, University of Valencia, Spain.
Pathology, Research and Practice +

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March 19, 2025

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March 19, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Assessing tumor budding and stroma in microsatellite-stable colon cancer helps identify high-risk patients. This combined histopathological approach improves recurrence risk stratification and reveals immune microenvironment characteristics.

Area Of Science

  • Oncology
  • Pathology
  • Cancer Research

Background

  • Microsatellite-stable (MSS) colon cancer is heterogeneous, necessitating identification of high-risk histopathological factors.
  • Tumor budding and tumor-associated stroma are morphological features linked to mesenchymal differentiation in colon cancer.

Purpose Of The Study

  • To develop a robust recurrence risk stratification score for MSS colon cancer using tumor budding and stroma.
  • To explore the relationship between this score and tumor microenvironment composition.
  • To evaluate the prognostic value of combined histopathological features over individual assessments.

Main Methods

  • Retrospective analysis of 254 MSS colon cancer (stages I-III) colectomy specimens.
  • Assessment of tumor budding and stroma using single hotspot and extended tumor area protocols.
  • Characterization of tumor microenvironment composition, including tertiary lymphoid structures, via immunohistochemistry.

Main Results

  • A three-tiered tumor budding-stroma (TBS) score, based on extended area assessment, was developed.
  • The TBS score was independently associated with disease-free survival, identifying a high-risk group.
  • The TBS score outperformed individual parameter assessments and hotspot-based scoring, correlating with an immune-depleted microenvironment.

Conclusions

  • Combined assessment of tumor budding and stroma over an extended area offers a comprehensive view of MSS colon cancer heterogeneity.
  • This approach provides a valuable tool for routine risk stratification in localized MSS colon cancer.
  • The TBS score aids in identifying patients with an immune-depleted tumor microenvironment, impacting prognosis.

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