Tumor Budding is an Independent Predictor of Outcome in AJCC/UICC Stage II Colorectal Cancer

Betge, Johannes; Kornprat, Peter; Pollheimer, Marion J.; Lindtner, Richard A.; Schlemmer, Andrea; Rehak, Peter; Vieth, Michael; Langner, Cord

doi:10.1245/s10434-012-2426-z

Cited by 101 publications

(86 citation statements)

References 30 publications

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“…Conversely Tregs increased in patients with a consistent residual disease (TRG 2/3) accompanied by increased tumour infiltration with higher CTLA4 and PD1-Treg. It was reported that CTLA-4 and PD-1, although inhibitory for T effector cells, have been implicated in the formation of inducible Tregs as well as in Treg suppressive function, respectively [27,28]. The biological responses of tumors to radiation include DNA damage, modulation of signal transduction, and alteration of the inflammatory tumor microenvironment [29].…”

Section: Discussionmentioning

confidence: 99%

Peripheral myeloid-derived suppressor and t-regulatory pd-1 positive cells predict response to neoadjuvant short-course radiotherapy in rectal cancer patients

Cardone¹,

Napolitano²,

Rega³

et al. 2016

European Journal of Surgical Oncology (EJSO)

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Section: Discussionmentioning

confidence: 99%

Peripheral myeloid-derived suppressor and t-regulatory pd-1 positive cells predict response to neoadjuvant short-course radiotherapy in rectal cancer patients

Cardone¹,

Napolitano²,

Rega³

et al. 2016

European Journal of Surgical Oncology (EJSO)

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“…In early lesions, it appears to be one of the strongest parameters associated with the presence of regional lymph-node spread 36,37. In patients with AJCC/UICC stage II disease, the extent of tumor budding could be used to select patients with node-negative cancers for adjuvant therapy50,65–67…”

Section: Prognostic Variables In Colorectal Cancermentioning

confidence: 99%

Prognostic stratification of colorectal cancer patients: current perspectives

Schneider

Langner

2014

CMAR

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Tumor staging according to the American Joint Committee on Cancer/Union for International Cancer Control tumor, node, metastasis (TNM) system is currently regarded as the standard for staging of patients with colorectal cancer. This system provides the strongest prognostic information for patients with early stage disease and those with advanced disease. For patients with intermediate levels of disease, it is less able to predict disease outcome. Therefore, additional prognostic markers are needed to improve the management of affected patients. Ideal markers are readily assessable on hematoxylin and eosin-stained tumor slides, and in this way are easily applicable worldwide. This review summarizes the histological features of colorectal cancer that can be used for prognostic stratification. Specifically, we refer to the different histological variants of colorectal cancer that have been identified, each of these variants carrying distinct prognostic significance. Established markers of adverse outcomes are lymphatic and venous invasion, as well as perineural invasion, but underreporting still occurs in the routine setting. Tumor budding and tumor necrosis are recent advances that may help to identify patients at high risk for recurrence. The prognostic significance of the antitumor inflammatory response has been known for quite a long time, but a lack of standardization prevented its application in routine pathology. However, scales to assess intra- and peritumoral inflammation have recently emerged, and can be expected to strengthen the prognostic significance of the pathology report.

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“…Specifically, budding, which is defined as the presence of isolated single cells or a small cluster of fewer than 5 cells scattered in the stroma at the invasive front [23,24], has been identified as an important prognostic parameter [25] and is particularly useful in AJCC/UICC stage II disease [26,27]. …”

Section: Histological Prognostic Parametersmentioning

confidence: 99%

Risk Assessment in Early Colorectal Cancer: Histological and Molecular Markers

Resch

Langner²

2014

Dig Dis

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The pathological examination of early colorectal cancer specimens, in particular ‘malignant polyps', provides important prognostic information. The depth of invasion into the submucosal layer assessed according to the Haggitt (for pedunculated lesions) or Kikuchi (for nonpolypoid lesions) classification systems or by direct measurement has been associated with the risk of lymph node metastasis. Angioinvasion, in particular lymphatic invasion, budding, tumor differentiation or grade, and resection margin status have been identified as further risk factors. The combination of these parameters allows the stratification of affected individuals into low- and high-risk categories, which is pivotal for clinical management. For low-risk cancers, defined as a completely excised Haggitt level 1-3/Kikuchi sm1 tumor with no evidence of poor differentiation or angioinvasion, local excision is generally regarded as adequate treatment. Oncological surgical resection is, however, indicated for high-risk cancers, which show at least one of the following features: Haggitt level 4/Kikuchi sm3 invasion, the presence of lymphatic (or vascular) invasion, poor differentiation, or positive resection margin. The inclusion of molecular markers such as tumor suppressor genes and their products, markers involved in tumor vascularization, and markers related to tumor cell adhesion and invasion may help to refine risk stratification, but data on molecular markers are still limited in this regard.

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Tumor Budding is an Independent Predictor of Outcome in AJCC/UICC Stage II Colorectal Cancer

Abstract: Tumor budding independently predicted patient outcome in patients with AJCC/UICC stage II colorectal cancer and may therefore be used for accurate prognostication, patient counseling, and design of clinical trials by using integrated multimodal therapy.

Cited by 101 publications

References 30 publications

Peripheral myeloid-derived suppressor and t-regulatory pd-1 positive cells predict response to neoadjuvant short-course radiotherapy in rectal cancer patients

Peripheral myeloid-derived suppressor and t-regulatory pd-1 positive cells predict response to neoadjuvant short-course radiotherapy in rectal cancer patients

Prognostic stratification of colorectal cancer patients: current perspectives

Risk Assessment in Early Colorectal Cancer: Histological and Molecular Markers

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