Tumor Budding is a Weak Predictor of Oncological Outcomes in Colorectal Cancer: A Cohort Study

• Background: Tumor budding (Bd) is a suggested risk factor for recurrence and decreased survival in colorectal cancer. Histopathological detection of Bd indicates increased invasive and migratory potential of the tumor cells.Objectives: This study aimed to explore the impact of Bd on oncological outcomes.Design: Retrospective cohort study.Patient and Methods: Patients treated with abdominal curative resection at Skåne University Hospital, Sweden, between 2017 and 2019 for colorectal adenocarcinoma were identified through the Swedish Colorectal Cancer Registry. Histopathological and medical records were reviewed retrospectively. Survival data were retrieved from the National Cause of Death registry.Main Outcome Measures: Primary outcomes were overall survival (OS), local recurrence (LR), and distant metastasis (DM) at 3 years.Sample Size: Seven hundred and sixty-eight patients were evaluated for inclusion. Two hundred and twenty-four patients were excluded due to stage 4 disease, early recurrence, or death within 90 days, R1/R2 resection, or missing histopathology regarding Bd.Results: Five hundred and forty-four patients were included for comparative analysis. One hundred and fifty-eight (29.0%) patients had histopathological signs of Bd. The mean follow-up was 33.8 (standard deviation, 6.6) months. Lymphovascular infiltration, tumor deposits, high tumor grade, and lymph node metastasis were prevalent in Bd-positive patients. Univariable Cox regression analysis showed decreased OS [hazard ratio (HR) = 2.30, 95% confidence interval (CI) = 1.30–3.31, P < 0.001] and increased DM (HR = 2.10, 95% CI = 1.32–3.34, P = 0.002), respectively. However, in multivariable Cox regression analysis, no significant results were observed: decreased OS (HR = 1.57, 95% CI = 0.95–2.59, P = 0.078) and DM (HR = 1.45, 95% CI = 0.86–2.47, P = 0.168). Bd was not associated with increased risk of LR.Conclusion: Bd was associated with other risk factors in colorectal cancer, which appear to be stronger prognostic indicators for oncological outcomes than Bd.Limitations: The study was limited by retrospective design. Three tier Bd-status was not provided for the entire study period.Conflict of Interest: The authors declare no financial or non-financial conflicts of interest.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

Publication and Content Type

art (subject category)

ref (subject category)