Tumor Budding at the Invasive Margin Can Predict Patients at High Risk of Recurrence After Curative Surgery for Stage II, T3 Colon Cancer

Abstract

The presence of moderate or severe budding at the invasive margin in Stage II, T3 colon cancer indicated a high risk of tumor recurrence after curative surgery, providing useful information for the decision regarding postoperative adjuvant chemotherapy.

Overexpression of the receptor for hyaluronic acid mediated motility is an independent adverse prognostic factor in colorectal cancer

“…Tumor budding is defined as the presence of isolated single cells or small cell clusters (up to 4) scattered in the stroma at the invasive tumor margin and is established as an adverse prognostic indicator. [28][29][30][31][32][33] Tumor budding is at least in part driven by the wnt signaling pathway as attested by the fact that nuclear b-catenin accumulates in the nuclei in tumor buds (dedifferentiated cancer cells) at the invasive tumor border. [34][35][36][37] In the present study, nuclear pERK expression was correlated with increasing RHAMM expression in MMR proficient (P ¼ 0.012) and with complete RHAMM expression in presumed Lynch syndrome (P ¼ 0.03), whereas an association was not found in MLH1-negative CRC.…”

Tumor budding in colorectal carcinoma: time to take notice

“…In one of the earlier studies of tumor budding, Hase et al 18 demonstrated that 5-year survival rates of Dukes B (stage II, T3-4 N0) patients with high-grade budding are significantly worse than those of Dukes C (N þ ) patients without budding (29 percent vs 66 percent; Po0.001). A number of more recent studies have confirmed that patients with Stage II colorectal carcinoma do significantly worse when high-grade budding is present, [34][35][36]38,41,45 and several studies have shown that survival rates of patients with Stage II colorectal carcinoma with high-grade budding are equivalent to survival rates of patients with Stage III colorectal carcinoma. [34][35][36] In their studies of Stage II and III pT3 tumors, Okuyama et al 34,35 found that tumor budding was the only factor on multivariate analysis to be associated with decreased survival and was more prognostically significant than lymph node metastases.…”

Invasive front of colorectal cancer: Dynamic interface ofpro-/anti-tumor factors

“…Tumor budding is frequently associated with poorly differentiated tumors, and with the presence of vascular and lymphatic invasion independently of disease extent [44][45][46][47][48] . Local tumor recurrence and distant metastasis to the lung and liver are also more commonly observed in patients with tumor budding [36,39,[48][49][50] and additionally represent a reproducible prognostic factor in stage Ⅱ patients [51] . Recently, Suzuki et al [52] found that tumor budding and venous invasion were significant predictors of local and distant metastases in patients with T1 stage colorectal cancers.…”