Tumor budding score based on 10 high-power fields is a promising basis for a standardized prognostic scoring system in stage II colorectal cancer

Horcic, Milo; Koelzer, Viktor H.; Karamitopoulou, Eva; Terracciano, Luigi; Puppa, Giacomo; Zlobec, Inti; Lugli, Alessandro

doi:10.1016/j.humpath.2012.07.026

Cited by 116 publications

(113 citation statements)

References 23 publications

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“…The presence of 5 of more tumor cells lacking a gland-like structure is defined as a poorly defined cluster [24]. The “10-high-power-field (HPF) method” is the preferred scoring mechanism and it is used in pre-keratin-stained sections [25, 26]. In this method, the invasive margin of the tumor is scanned at a low magnification to find the densest budding region, and subsequently all tumor budding foci in 10 HPF within this region are counted.…”

Section: Intertumor Heterogeneitymentioning

confidence: 99%

Tumor Heterogeneity in Colorectal Cancer: What Do We Know So Far?

Sagaert¹,

Vanstapel²,

Verbeek³

2018

Pathobiology

138

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Colorectal cancer is not one disease but rather a collection of neoplastic diseases. Due to heterogeneity in the disease biology, therapy response, and prognosis, extensive disease stratification is required. Therefore, TNM stage, microsatellite status, tumor grade, lymphovascular invasion, and other parameters are assessed in the pathology report to indicate the extent and prognosis of the disease. The mutation status of KRAS, BRAF, and NRAS is also investigated in a metastatic context to predict the response to anti-EGFR therapy. Recently, 4 distinct molecular subtypes of colorectal cancer have been described that have both prognostic and therapeutic relevance. In addition, characterization of the inflammatory infiltrate revealed major differences in the amount and location of inflammatory cells in distinct colorectal tumor types. Together, all of these parameters help to stratify patients into different therapeutic and prognostic subgroups. However, this stratification is not unambiguous since tumors often display intratumoral heterogeneity, whereby several subpopulations within one tumor show differences in morphology, inflammatory infiltrate, mutational status, or gene expression profile. This article gives an overview of all of the current known data with regard to tumor heterogeneity at both inter- and intratumoral levels.

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Section: Intertumor Heterogeneitymentioning

confidence: 99%

Tumor Heterogeneity in Colorectal Cancer: What Do We Know So Far?

Sagaert¹,

Vanstapel²,

Verbeek³

2018

Pathobiology

138

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“…Recent studies have addressed the role of tumor budding in resected colorectal specimens. [14][15][16] Tumor budding within the entire tumor, rather than at the invasive front, is termed intra-tumoral budding 17 and has been described in both colorectal cancer biopsy and resected specimens. 18,19 This study addresses the prognostic and predictive power of tumor budding in biopsy specimens at the time of diagnosis of locally advanced rectal cancer.…”

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confidence: 99%

Prognostic significance of tumor budding in rectal cancer biopsies before neoadjuvant therapy

et al. 2014

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Tumor budding is an increasingly important prognostic feature for pathologists to recognize. The aim of this study was to correlate intra-tumoral budding in pre-treatment rectal cancer biopsies with pathological response to neoadjuvant chemoradiotherapy and with long-term outcome. Data from a prospectively maintained database were acquired from patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiotherapy. Pre-treatment rectal biopsies were retrospectively reviewed for evidence of intra-tumoral budding. Multivariate logistic regression was used to identify factors contributing to cancer-specific death, expressed as hazard ratios with 95% confidence intervals. Of the 185 patients with locally advanced rectal cancer, 89 patients met the eligibility criteria, of whom 18 (20%) exhibited budding in a pre-treatment tumor biopsy. Intra-tumoral budding predicted a poor pathological response to neoadjuvant chemoradiotherapy (higher ypT stage, P ¼ 0.032; lymph node involvement, P ¼ 0.018; lymphovascular invasion, P ¼ 0.004; and residual poorly differentiated tumors, P ¼ 0.005). No patient with intra-tumoral budding exhibited a tumor regression grade 1 or complete pathological response, providing a 100% specificity and positive predictive value for non-response to neoadjuvant chemoradiotherapy. Intra-tumoral budding was associated with a lower disease-free 5-year survival rate (33 vs 78%, Po0.001), cancer-specific 5-year survival rate (61 vs 87%, P ¼ 0.021) and predicted cancer-specific death (hazard ratio 3.51, 95% confidence interval 1.03-11.93, P ¼ 0.040). Intratumoral budding at diagnosis of rectal cancer identifies those who will poorly respond to neoadjuvant chemoradiotherapy and those with a poor prognosis.

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“…Bei Vorliegen von 5 oder mehr Tumorzellen ohne drüsenähnliche Strukturen handelt es sich definitionsgemäß um ein schlecht differenziertes Cluster [24]. Bevorzugtes Scoring-Verfahren ist die 10-HPF-Methode (HPF = high-power field), die an Gewebeschnitten mit Präkeratinfärbung durchgeführt wird [25,26]. Bei dieser Methode wird der invasive Tumorrand bei geringer Vergrößerung beurteilt, um die Region mit der dichtesten Tumorknospung zu ermitteln, und anschließend werden alle Herde mit Tumorknospung in 10 HPF in dieser Region gezählt.…”

Section: Histopathologische Heterogenitätunclassified

Tumorheterogenität des kolorektalen Karzinoms: Was wir bisher wissen

Vanstapel¹,

Verbeek²

2019

Kompass Onkol

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Das Kolorektalkarzinom ist keine einzelne Erkrankung, sondern umfasst vielmehr eine Gruppe von neoplastischen Erkrankungen. Aufgrund der Heterogenität der Erkrankung sowie des Therapieansprechens und der Prognose ist eine umfangreiche Stratifizierung der Krankheit erforderlich. Daher werden im Pathologiebericht TNM-Stadium, Mikrosatellitenstatus, Tumorgrad, Lymphgefäßeinbruch und andere Parameter bewertet, um das Ausmaß und die Prognose der Erkrankung aufzuzeigen. Ferner wird bei einer Metastasierung der KRAS-, BRAF- und NRAS-Mutationsstatus untersucht, um das Ansprechen auf eine Anti-EGFR-Therapie (EGFR = epidermaler Wachstumsfaktorrezeptor) vorherzusagen. Kürzlich wurden 4 unterschiedliche molekulare Subtypen des Kolorektalkarzinoms beschrieben, die sowohl von prognostischer als auch von therapeutischer Relevanz sind. Darüber hinaus zeigten sich in der Untersuchung des entzündlichen Infiltrats wesentliche Unterschiede hinsichtlich der Anzahl und Lokalisation der Entzündungszellen bei den verschiedenen Kolorektalkarzinomtypen. Die Gesamtheit dieser Parameter ermöglicht eine Stratifizierung der Patienten in verschiedene therapeutische und prognostische Subgruppen. Eine solche Stratifizierung ist jedoch nicht eindeutig, da Tumoren häufig intratumorale Heterogenität aufweisen, bei der verschiedene Subpopulationen innerhalb eines Tumors Unterschiede hinsichtlich Morphologie, entzündlichem Infiltrat, Mutationsstatus oder Genexpressionsprofil zeigen. Der vorliegende Artikel gibt einen Überblick über alle derzeit bekannten Daten zur Tumorheterogenität sowohl auf inter- als auch auf intratumoraler Ebene.

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Tumor budding score based on 10 high-power fields is a promising basis for a standardized prognostic scoring system in stage II colorectal cancer

Cited by 116 publications

References 23 publications

Tumor Heterogeneity in Colorectal Cancer: What Do We Know So Far?

Tumor Heterogeneity in Colorectal Cancer: What Do We Know So Far?

Prognostic significance of tumor budding in rectal cancer biopsies before neoadjuvant therapy

Tumorheterogenität des kolorektalen Karzinoms: Was wir bisher wissen

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