Tumor budding in colorectal cancer revisited: results of a multicenter interobserver study.

Kölzer, Viktor; Zlobec, Inti; Berger, Martin D; Cathomas, Gieri; Dawson, Heather; Dirschmid, Klaus; Hädrich, Marion; Inderbitzin, Daniel; Offner, Felix; Puppa, Giacomo; Seelentag, Walter; Schnüriger, Beat; Tornillo, Luigi; Lugli, Alessandro (2015). Tumor budding in colorectal cancer revisited: results of a multicenter interobserver study. Virchows Archiv, 466(5), pp. 485-493. Springer 10.1007/s00428-015-1740-9

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Tumor budding in colorectal cancer (CRC) is recognized as a valuable prognostic factor but its translation into daily histopathology practice has been delayed by lack of agreement on the optimal method of assessment. Within the context of the Swiss Association of Gastrointestinal Pathology (SAGIP), we performed a multicenter interobserver study on tumor budding, comparing hematoxylin and eosin (H&E) with pan-cytokeratin staining using a 10 high power field (10HPF) and hotspot (1HPF) method. Two serial sections of 50 TNM stage II-IV surgically treated CRC were stained for H&E and pan-cytokeratin. Tumor buds were scored by independent observers at six participating centers in Switzerland and Austria using the 10HPF and 1HPF method on a digital pathology platform. Pearson correlation (r) and intra-class correlation coefficients (ICC) comparing scores between centers were calculated. Three to four times more tumor buds were detected in pan-cytokeratin compared to H&E slides. Correlation coefficients for tumor budding counts between centers ranged from r = 0.46 to r = 0.91 for H&E and from r = 0.73 to r = 0.95 for pan-cytokeratin slides. Interobserver agreement across all centers was excellent for pan-cytokeratin [10HPF: ICC = 0.83 and 1HPF: ICC = 0.8]. In contrast, assessment of tumor budding on H&E slides reached only moderate agreement [10HPF: ICC = 0.58 and 1HPF: ICC = 0.49]. Based on previous literature and our findings, we recommend (1) pan-cytokeratin staining whenever possible, (2) 10HPF method for resection specimens, and (3) 1HPF method for limited material (preoperative biopsy or pT1). Since tumor budding counts can be used to determine probabilities of relevant outcomes and as such more optimally complement clinical decision making, we advocate the avoidance of cutoff scores.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology

UniBE Contributor:

Kölzer, Viktor; Zlobec, Inti; Dawson, Heather; Hädrich, Marion; Inderbitzin, Daniel; Schnüriger, Beat and Lugli, Alessandro

Subjects:

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

ISSN:

0945-6317

Publisher:

Springer

Language:

English

Submitter:

Doris Haefelin

Date Deposited:

13 Jul 2015 14:42

Last Modified:

14 Feb 2016 22:39

Publisher DOI:

10.1007/s00428-015-1740-9

PubMed ID:

25701480

BORIS DOI:

10.7892/boris.70190

URI:

https://boris.unibe.ch/id/eprint/70190

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