Are tumour grade and tumour budding equivalent in colorectal cancer? A retrospective analysis of 771 patients.

Zlobec, Inti; Dawson, Heather E.; Blank, Annika; Bokhorst, John-Melle; Berger, Martin D.; Nagtegaal, Iris D; Lugli, Alessandro (2020). Are tumour grade and tumour budding equivalent in colorectal cancer? A retrospective analysis of 771 patients. European journal of cancer, 130, pp. 139-145. Elsevier 10.1016/j.ejca.2020.02.007

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BACKGROUND Tumour grade is traditionally considered in the management of patients with colorectal cancer. However, a large body of literature suggests that a related feature, namely tumour budding, may have a more important clinical impact. The aim of our study is to determine the correlation between tumour grade and tumour budding and their impact on patient outcome. METHODS A retrospective collective of 771 patients with colorectal cancer were included in the study. Clinicopathological information included tumour grade (World Health Organisation 2010; G1, G2 and G3) and tumour budding evaluated as BD1, BD2 and BD3 and representing 0-4 buds, 5-9 buds and 10 or more buds per 0.785 mm2, respectively. RESULTS Tumour grade and tumour budding were correlated (p < 0.0001, percent concordance: 33.8%). Of the BD1 cases, 18.1% were of G3. Only two BD3 cases were G1. Both high tumour grade and tumour budding were associated with higher pT, lymph node metastasis, distant metastasis and lymphatic and venous vessel invasion (p < 0.01, all), but only tumour grade was additionally associated with right-sided tumour location and mucinous histology. Higher tumour budding led to worse overall (p = 0.0286) and disease-free survival (p = 0.001), but tumour grade did not. Budding was independent of tumour grade in multivariate analysis. DISCUSSION Tumour grade and tumour budding are distinct features, as recognised by their different clinicopathological associations, reflecting different underlying biological processes. Nonetheless, tumour budding seems to outperform tumour grade in terms of predicting disease-free survival.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Zlobec, Inti; Dawson, Heather; Blank, Annika; Berger, Martin Dave and Lugli, Alessandro

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0959-8049

Publisher:

Elsevier

Language:

English

Submitter:

Rebeka Gerber

Date Deposited:

24 Apr 2020 15:19

Last Modified:

24 Apr 2020 15:31

Publisher DOI:

10.1016/j.ejca.2020.02.007

PubMed ID:

32200222

Uncontrolled Keywords:

Colorectal cancer Prognosis Tumour budding Tumour grade

BORIS DOI:

10.7892/boris.143025

URI:

https://boris.unibe.ch/id/eprint/143025

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