Histologic Features Associated with Lymph Node Metastasis in Stage T1 and Superficial T2 Rectal Adenocarcinomas in Abdominoperineal Resection Specimens: Identifying a Subset of Patients for Whom Treatment with Adjuvant Therapy or Completion Abdominoperineal Resection should be Considered After Local Excision

Goldstein, Neal S.; Hart, John

doi:10.1093/ajcp/111.1.51

Cited by 86 publications

(71 citation statements)

References 21 publications

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“…Our results are concordant with the results of Morodomi et al, Goldstein et al, and Okuyama et al, who reported that tumor budding is associated with pathological parameters including venous invasion and lymph node metastasis in colorectal carcinomas (10,18,19). These findings support the idea that tumor buds originate from the cells which have higher malignant potential.…”

Section: Resultssupporting

confidence: 93%

Tumor budding in colorectal carcinomas

Bektas

Mamak²,

Çiriş³

et al. 2012

TJPATH

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Objective: In colorectal carcinomas, tumor budding has been defined as the presence of isolated single tumor cells or small cell clusters in the stroma at the invasive tumor margin. In this study, the relationship between tumor budding density at the invasive tumor margin and pathological parameters is investigated. Material and Method:Haematoxylin and eosin stained slides of 73 cases with colorectal carcinoma were retrospectively evaluated for the presence and intensity of tumor budding by 2 observers. After the specimens were assessed, the highest density of tumor budding area was counted in a microscopic field of x200. Cases were separated into 2 groups according to tumor budding density as low grade (<10) and high grade (≥10). The relationship of these groups with depth of tumor invasion, histological grade, vascular invasion and lymph node involvement was investigated. Results:Of the 73 colorectal carcinoma cases, 33 (45.2%) had low and 40 (54.8%) had high grade tumor budding density, respectively. There was a statistically significant relationship between high grade tumor budding density and histological grade (p=0.042), lymph node involvement (p=0.0001) and vascular invasion (p=0.0034). Conclusion:High grade tumor budding density is associated with aggressive phenotypical features in colorectal carcinoma.Key Words: Colorectal neoplasms, Neoplasm invasion, Lymph node, Metastasis ÖZ Amaç: Kolorektal karsinomlarda tümör tomurcuklanması, invaziv tümör komşuluğundaki stromada bulunan izole tümör hücreleri ya da küçük tümöral hücre kümeleri olarak tanımlanmaktadır. Bu çalışmada kolorektal karsinomlarda invaziv tümör komşuluğundaki stromada bulunan tümör tomurcuklanması yoğunluğunun patolojik özelliklerle ilişkisi araştırılmıştır. Gereç ve Yöntem:Retrospektif olarak, kolorektal karsinomlu 73 olguya ait hematoksilen-eozin boyalı preparatlar tümör tomurcuklanması varlığı ve yoğunluğunun tespit edilmesi amacıyla 2 gözlemci tarafından değerlendirilmiştir. Preparatlar tekrar değerlendirildikten sonra tümör tomurcuklanmaları, en yoğun oldukları alan tespit edilerek x200 büyütme alanında sayılmıştır. Olgular, tümör tomurcuklanması yoğunluğu 10' dan az olanlar düşük dereceli, 10 ve üzeri olanlar yüksek dereceli olmak üzere 2 gruba ayrılmıştır. Bu grupların tümörün invazyon derinliği, histolojik derecesi, lenf nodu tutulumu ve vasküler invazyon gibi patolojik özelliklerle ilişkisi araştırılmıştır. Bulgular: Kolorektal karsinomlu 73 olgunun 33'ünde (%45,2) düşük, 40'ında (%54,8) yüksek dereceli tümör tomurcuklanması yoğunluğu tespit edilmiştir. Yüksek dereceli tümör tomurcuklanması yoğunluğu ile histolojik derece (p=0.042), lenf nodu tutulumu (p=0,0001) ve vasküler invazyon (p=0,0034) arasında istatistiksel olarak anlamlı ilişki saptanmıştır.Sonuç: Yüksek dereceli tümör tomurcuklanması yoğunluğu kolorektal karsinomlarda agresif fenotipik özelliklerle ilişkilidir.

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Section: Resultssupporting

confidence: 93%

Tumor budding in colorectal carcinomas

Bektas

Mamak²,

Çiriş³

et al. 2012

TJPATH

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“…Hase et al (1993) reported that tumour budding was an important predictor for recurrence and poor prognosis in patients with colorectal cancers. Furthermore, some oncologists and pathologists showed that tumour budding was significantly associated with lymph node metastasis, local recurrence, distant metastasis and poor prognosis in advanced colorectal cancers (Ono et al, 1996;Goldstein and Hart, 1999;Okuyama et al, 2002;Ueno et al, 2002). In previous reports, tumour budding was detected by using H.E specimens.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is difficult to identify a lymphatic involvement by cancer cells with routine haematoxylin and eosin (H.E) staining and both the sensitivity and the positive predictive value of this risk factor for lymph node metastasis remain low. Studies of advanced colorectal cancers have recently demonstrated that tumour budding at the invasive margin is a risk factor for lymph node metastasis (Morodomi et al, 1989;Hase et al, 1993;Ono et al, 1996;Goldstein and Hart, 1999;Okuyama et al, 2002;Ueno et al, 2002;Tanaka et al, 2003;Park et al, 2005). However, so far there have been few studies that have examined tumour budding in submucosal carcinomas with respect to lymph node metastasis (Makino et al, 2000;Masaki et al, 2001b;Ueno et al, 2004).…”

mentioning

confidence: 99%

Tumour budding at the deepest invasive margin correlates with lymph node metastasis in submucosal colorectal cancer detected by anticytokeratin antibody CAM5.2

et al. 2006

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In the past few years, tumour budding at the invasive margin has been reported as a new risk factor for lymph node metastasis in advanced colorectal cancers, but it is sometimes difficult to detect tumour budding in submucosal colorectal cancer by haematoxylin and eosin staining. We immunohistochemically examined tumour budding at the deepest invasive margin of 56 surgically resected submucosal colorectal carcinomas using anticytokeratin antibody CAM5.2, furthermore checked by AE1/AE3, and determined the relation between tumour budding and clinicopathological factors. Moreover, we used the monoclonal antibody D2-40 for immunohistochemistry to detect lymphatic involvement. Tumour budding was detected in 42 cases (75.0%), and the buddingpositive group showed a significantly higher rate of lymph node metastasis (including isolated tumour cells) (16/42 vs 0/14; P ¼ 0.004) than the budding-negative group. The sensitivity and negative predictive value of tumour budding alone for lymph node metastasis were superior to those of lymphatic invasion alone. Furthermore, the specificity and positive predictive value of the combination of either lymphatic invasion or tumour budding were superior to those of lymphatic invasion alone. Tumour budding detected immunohistochemically by using CAM5.2 is a newly found risk factor for lymph node metastasis and may help to avoid oversurgery in the future.

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“…Among the suggested grading schemes, both the number of strata, as well as the criteria for distinguishing among them, vary markedly. In some systems, grade is defined on the basis of a single microscopic feature, such as the degree of gland formation, and in other systems, a large number of features are included in the evaluation (14). Irrespective of the complexity of the criteria, however, most systems stratify tumors into three or four grades as follows:…”

Section: Sporadic Colorectal Cancer: the Basics That Are Not So Basicmentioning

confidence: 99%

Colorectal Carcinoma: Diagnostic, Prognostic, and Molecular Features

2003

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Surgical resection is the primary treatment modality for colorectal cancer, and the pathologic assessment of the resection specimen provides data that is essential for patient management, including the estimation of postoperative outcome and the rationale for adjuvant therapy. The essential elements of the pathological assessment of colorectal cancer resection specimens include the pathologic determination of TNM stage, tumor type, histologic grade, status of resection margins, and vascular invasion. The prognostic and/or predictive value of these elements, as well as guidelines for their derivation and interpretation, are reviewed in detail. Other tissue-based prognostic factors that are strongly suggested by existing data to have stageindependent prognostic value or to predict response to adjuvant therapy but that have not yet been validated for routine patient care are also reviewed. These include perineural invasion, tumor border configuration, host immune response to tumor, and molecular features such as microsatellite instability or loss of heterozygosity of chromosome 18. The need for high-quality, reproducible pathologic data in the care of the colorectal cancer patient, and the dependence of that data on standardization of all aspects of pathological assessment, is emphasized. In short, colorectal cancer is by far the most common malignancy of the gastrointestinal tract, and it is, without question, a "surgical disease." An estimated 92% of colon cancer patients and 84% of rectal cancer patients undergo surgical resection as the primary modality of treatment; the procedure is most typically performed with curative intent. The appropriateness of adjuvant therapy and the prediction of outcome for the patient are, to a large extent, based on the pathologic assessment of the local disease and other tissue-based prognostic factors in the resection specimen. The problems and controversies associated with the assessment of the colorectal resection specimen, and the current recommendations for their interpretation and reporting, are reviewed. SPORADIC COLORECTAL CANCER: THE BASICS THAT ARE NOT SO BASICThe pathology report of a colorectal cancer resection specimen typically documents the anatomic site of the malignancy, the histologic type, the parameters that determine the local tumor stage, and the histopathologic confirmation of distant metastasis, if applicable. Other reported features include those having additional prognostic (related to likelihood of survival) or predictive (related to likelihood of response to therapy) value, as well as those that may be important for clinicopathologic correlation or quality control (e.g., actual tumor size versus size measurement by imaging techniques). Although basic to pathologic assessment, the definition and interpretation of many of these key features is controversial. The lack of consensus on and standardization of interpretation of these features is the basis of much of the variation in pathologic assessment of colorectal cancers. Variability in assessment, in tu...

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Abstract: llmage 21 Grade 3 (poorly differentiated) adenocarcinoma.The neoplasm is formed by complex, irregular, cribriform glands and small solid areas (H&E, x76.8).5 2 Am J Clin Pathol 1999;111:51-58

Cited by 86 publications

References 21 publications

Tumor budding in colorectal carcinomas

Tumor budding in colorectal carcinomas

Tumour budding at the deepest invasive margin correlates with lymph node metastasis in submucosal colorectal cancer detected by anticytokeratin antibody CAM5.2

Colorectal Carcinoma: Diagnostic, Prognostic, and Molecular Features

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