Tumor Budding in colorectal cancer: clinicopathological evaluation of the negative impact on the oncological progression in stages II and III

Abstract

Abstract Introduction: Tumor Budding (TB) is considered as an independent adverse prognostic marker in colorectal cancer (CRC). The prognostic impact of TB at the tumor invasive front in CCR remains unclear, hence institutional practices on the description of TB and methods for its assessment widely vary. Methods: Between 01/2017 and 12/2022, patients undergoing colectomy or attempted rectal resection for CCR were identified. Patients with diagnosis of colorrectal adenocarcinoma, stage M0 at the moment of surgery, and description of the TB status in pathological report were included in our study. The effect of TB on histological factors, clinical stage, local recurrence rate, disease-free (DFS) and overall survival (OS) was assessed. Results: TB was present in 56 patients (71,8%), including low grade in 22 (39,3%), intermediate grade 17 (30,4%) and high grade 17 (30,4%) patients. The proportion of patients showing regional lymph node metastasis, lymphovascular and perineural invasión was significantly higher in patients with TB (26,8% vs 0%, p = 0,008; 41,1% vs 4,5%, p = 0,002; 16,1% vs 0% p = 0,054; respectively). DFS was 86,3% in TB low, 75,3% in TB intermediate, and 70,3% in TB high grade, respectively. Intermediate and high grade TB were associated with shorter OS compared to low TB (93,7% and 75,4% vs 100%, respectively p = 0,012). Conclusions: These results suggest that the TB expression may be a useful risk factor for lymph node metastasis, local recurrence and distant metastasis. TB at the tumor invasive front is associated with shorter OS after curative surgery for CRC.