Tumor Budding Is Independently Predictive for Lymph Node Involvement in Early Gastric Cancer

Güllüoğlu, Mine; Yeğen, Gülçin; Özlük, Yasemin; Keskin, Metin; Doğan, Serap; Gundogdu, Gokcen; Önder, Semen; Balık, Emre

doi:10.1177/1066896915581200

Cited by 43 publications

(56 citation statements)

References 61 publications

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“…However, on multivariate analysis higher tumor bud scores were also associated with recurrence (hazard ratio 1.60), but the P-value approached, but did not meet significance (P=0.08). Our results agree with previous research [18,25,26], supporting the hypothesis that increased tumor budding in GAC portends an increased risk of adverse outcomes, including lymph node involvement and recurrence. However, more studies are needed to better analyze the value of tumor budding in gastric carcinoma.…”

Section: Accepted Manuscriptsupporting

confidence: 95%

“…Similar studies have also shown a similar relationship in adenocarcinomas of the ampulla [21], esophagus [22,23], and pancreas [24]. However, very little research has been performed evaluating tumor budding in GAC [18,25,26]. The aim of this study is to further evaluate the prognostic value that tumor budding may have in GAC.…”

Section: Accepted Manuscriptmentioning

confidence: 63%

“…Of note, similar to our methodology, both of these investigators excluded the signet ring and undifferentiated tumors from their analysis. Gulluoglu et al also found that on multivariate analysis, the only parameter that was associated with tumor budding was lymph node metastasis [26]. However, their study included only early gastric cancers with all histologic subtypes.…”

Section: Accepted Manuscriptmentioning

confidence: 96%

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Tumor budding in intestinal-type gastric adenocarcinoma is associated with nodal metastasis and recurrence

et al. 2017

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Section: Accepted Manuscriptsupporting

confidence: 95%

Section: Accepted Manuscriptmentioning

confidence: 63%

Section: Accepted Manuscriptmentioning

confidence: 96%

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Tumor budding in intestinal-type gastric adenocarcinoma is associated with nodal metastasis and recurrence

et al. 2017

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“…These findings suggest that tumor budding is a frequent early event of cervical cancer dissemination and is associated with cervical cancer progression. Similar results have been demonstrated in colorectal carcinoma [21, 26], breast cancer [16], and gastric cancer [27]. The budding cells at the invasive tumor front are considered epithelial mesenchymal transition (EMT)-derived tumor cells, with increased migratory and invasive capacities and stem cell properties [21, 28, 29].…”

Section: Discussionsupporting

confidence: 58%

High-Grade Tumor Budding Stratifies Early-Stage Cervical Cancer with Recurrence Risk

Huang

Cai

et al. 2016

PLoS ONE

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ObjectivesThis study investigated prognostic significance of tumor budding in early-stage cervical cancer (ESCC) following radical surgery and its contribution to improve the stratification of patients with recurrence risk.MethodsThe archival medical records and H&E-stained slides of 643 patients with IA2-IIA stage cervical cancer who underwent radical surgery were retrospectively reviewed. Clinicopathological parameters were noted, and tumor buds were counted using immunohistochemistry for each case. The prognostic significance of tumor budding was analyzed. Prediction models that comprised tumor budding were established, and the performance was compared between the novel models and classic criteria via log-rank test and receiver operating characteristic analysis.ResultsTumors with high-grade tumor budding (HTB) exhibited a substantially increased risk of recurrence (hazard ratio = 4.287, P < 0.001). Nine predictive models for recurrence were established, in which HTB was combined with recognized risk factors. The model using of at least two risk factors of HTB, tumor size ≥ 4 cm, deep stromal invasion of outer 1/3, and lymphovascular space invasion to stratify patients with an intermediate risk was most predictive of recurrence compared with the classic criteria.ConclusionsTumor budding is an independent, unfavorable, prognostic factor for ESCC patients following radical surgery and holds promise for improved recurrence risk stratification.

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“…7 The prognostic value of tumor budding in gastric cancer is poorly known. Two of the four earlier small studies have suggested that budding may associate to poor prognosis in gastric cancer, [8][9][10][11] but none of the four studies counted buds from a single field of vision on hematoxylin-eosin stained slides, which is now recommended in colorectal cancer. 4 The aim of this study was to evaluate the reproducibility of the assessment of tumor budding with the contemporary methods and to clarify the prognostic value of tumor budding in gastric adenocarcinoma and its histological subsets in a large cohort.…”

Section: Introductionmentioning

confidence: 99%

Tumor Budding and Prognosis in Gastric Adenocarcinoma

Kemi

Eskuri

Ikäläinen

et al. 2019

American Journal of Surgical Pathology

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Tumor budding has been associated with poor prognosis in several cancer types, but its significance in gastric cancer is unknown. The aim of this study was to assess the prognostic significance of tumor budding in gastric adenocarcinoma, and its main histological types. Some 583 gastric adenocarcinoma patients who underwent surgery in Oulu University Hospital during the years 1983-2016 were included in this retrospective cohort study. Tumor budding was counted per 0,785mm 2 fields from the slides originally used for diagnostic purposes. Patients were divided into low-(<10 buds) and high budding (≥10 buds) groups. Tumor budding was analyzed in relation to 5year survival and overall survival. Cox regression was used to calculate hazard ratios (HR) with 95% confidence intervals (CI), adjusted for confounders. Determining tumor budding was difficult in diffuse type cancer due to the uncohesive growth pattern of these tumors. Patients with high tumor budding had worse 5-year survival compared to patients with low tumor budding (adjusted HR 1.55, 95% CI 1.20 -2.01). In intestinal type adenocarcinomas, the high budding group had significantly poorer 5-year survival compared to the low budding group (adjusted HR 1.57, 95% CI 1.14-2.15). There were no differences in 5-year survival between the budding groups in the diffuse type adenocarcinoma. In conclusion, high tumor budding is an independent prognostic factor in gastric adenocarcinoma, but its value is limited to intestinal type of gastric adenocarcinoma. In diffuse type gastric adenocarcinoma, the assessment of tumor budding is hardly feasible and it does not have prognostic relevance.

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Tumor Budding Is Independently Predictive for Lymph Node Involvement in Early Gastric Cancer

Abstract: Based on these results, we suggest that budding is a promising parameter to assess for prediction of LNM in EGC removed by endoscopic surgery, and to decide on the appropriate surgical approach.

Cited by 43 publications

References 61 publications

Tumor budding in intestinal-type gastric adenocarcinoma is associated with nodal metastasis and recurrence

Tumor budding in intestinal-type gastric adenocarcinoma is associated with nodal metastasis and recurrence

High-Grade Tumor Budding Stratifies Early-Stage Cervical Cancer with Recurrence Risk

Tumor Budding and Prognosis in Gastric Adenocarcinoma

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