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Intensity of Tumor Budding and Its Prognostic Implications in Invasive Colon Carcinoma

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Diseases of the Colon & Rectum

PURPOSE

The aim of this study was to assess the intensity of tumor budding in colon carcinoma quantitatively and to determine its correlation with malignancy potential.

METHODS

The intensities of tumor budding at the invasive front of surgical specimens from 174 patients with well-differentiated or moderately differentiated colon carcinoma were investigated. Differences in intensity among clinicopathologic parameters were compared, and recurrences and survivals were analyzed in accordance with degree of the intensity.

RESULTS

Tumor budding was identified in 155 patients (89 percent) and the mean intensity (± standard deviation) of budding was, on the whole, 6.6 ± 5.6. Intensity was significantly higher in tumors with lymphatic and vascular invasion than in those without (9.1 ± 6.6 vs. 4.8 ± 3.9 and 9.8 ± 6.1 vs. 5.4 ± 4.9; P < 0.0001, respectively). It became significantly higher with increasing T and N stage (P = 0.0013 and < 0.0001, respectively). Both the Cox model and the linear logistic regression indicated that higher intensity was significantly associated with higher risk of postoperative recurrence (P = 0.017 and 0.0001, respectively). When patients were stratified into four groups based on the quartiles of the distribution of intensity, the group of higher quartiles showed significantly less favorable outcome in terms of both five-year disease-free (P = 0.0039) and overall survival (P = 0.0263). The cutoff of the intensity considered to be the best indicator for separating patients with regard to survival was third quartiles (intensity, 9). Based on multivariate analysis, the intensity of budding proved to be a significant covariate associated with disease-free survival (hazard ratio, 2.061; P = 0.0066).

CONCLUSIONS

The intensity of tumor budding at the invasive margin is suggested to be a significant pathologic index, indicating higher malignancy potential and the intensity greater than nine may be considered an adverse prognostic indicator in patients with colon carcinoma.

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REFERENCES

  1. T Morodomi H Isomoto K Shirouzu K Kakegawa K Irie M Morimatsu (1989) ArticleTitleAn index for estimating the probability of lymph node metastasis in rectal cancers. Lymph node metastasis and the histopathology of actively invasive regions of cancer Cancer 63 539–43 Occurrence Handle2912530

    PubMed  Google Scholar 

  2. K Hase C Shatney D Johnson M Trollope M Vierra (1993) ArticleTitlePrognostic value of tumor “budding” in patients with colorectal cancer Dis Colon Rectum 36 627–35 Occurrence Handle8348847

    PubMed  Google Scholar 

  3. T Okuyama M Oya H Ishikawa (2003) ArticleTitleBudding as a useful prognostic marker in pT3 well- or moderately-differentiated rectal adenocarcinoma J Surg Oncol 83 42–7 Occurrence Handle10.1002/jso.10230 Occurrence Handle12722096

    Article  PubMed  Google Scholar 

  4. H Ueno J Murphy JR Jass H Mochizuki IC Talbot (2002) ArticleTitleTumour ‘budding’ as an index to estimate the potential of aggressiveness in rectal cancer Histopathology 40 127–32 Occurrence Handle10.1046/j.1365-2559.2002.01324.x Occurrence Handle11952856

    Article  PubMed  Google Scholar 

  5. M Tanaka Y Hashiguchi H Ueno K Hase H Mochizuki (2003) ArticleTitleTumor budding at the invasive margin can predict patients at high risk of recurrence after curative surgery for Stage II, T3 colon cancer Dis Colon Rectum 46 1054–9 Occurrence Handle10.1007/s10350-004-7280-z Occurrence Handle12907899

    Article  PubMed  Google Scholar 

  6. T Okuyama M Oya H Ishikawa (2002) ArticleTitleBudding as a risk factor for lymph node metastasis in pT1 or pT2 well-differentiated colorectal adenocarcinoma Dis Colon Rectum 45 628–34 Occurrence Handle10.1007/s10350-004-6259-0 Occurrence Handle12004212

    Article  PubMed  Google Scholar 

  7. Jass JR, Sobin LH. Histologic typing of intestinal tumors. In WHO international histological classification of tumors. 2th ed. Berlin: Springer-Verlag, 1989

  8. CE Dukes (1932) ArticleTitleThe classification of cancer of the rectum J Pathol Bacteriol 35 323–32

    Google Scholar 

  9. DR Cox (1972) ArticleTitleRegression models and life tables J R Stat Soc Series B 34 187–220

    Google Scholar 

  10. McCullagh P, Nelder JA. Generalized linear models. 2nd ed. London: Chapman and Hall, 1989

  11. N Mantel (1966) ArticleTitleEvaluation of survival data and two new rank order statistics arising in its consideration Cancer Chemother Rep 50 163–70 Occurrence Handle5910392

    PubMed  Google Scholar 

  12. T Imai (1954) ArticleTitleThe growth of human carcinoma: a morphological analysis [in Japanese] Fukuoka Igaku Zasshi 45 72–102

    Google Scholar 

  13. K Hase CH Shatney H Mochizuki et al. (1995) ArticleTitleLong-term results of curative resection of “minimally invasive” colorectal cancer Dis Colon Rectum 38 19–26 Occurrence Handle7813339

    PubMed  Google Scholar 

  14. CR Teixeira S Tanaka K Haruma et al. (1994) ArticleTitleCarcinoembryonic antigen staining patterns at the invasive tumor margin predict the malignant potential of colorectal carcinoma Oncology 51 228–33 Occurrence Handle7515172

    PubMed  Google Scholar 

  15. PC Nowell (1986) ArticleTitleMechanisms of tumor progression Cancer Res 46 2203–7 Occurrence Handle3516380

    PubMed  Google Scholar 

  16. P Frost B Levin (1992) ArticleTitleClinical implications of metastatic process Lancet 339 1458–61 Occurrence Handle1351135

    PubMed  Google Scholar 

  17. T Masaki H Matsuoka M Sugiyama et al. (2003) ArticleTitleLaminin-5 γ2 chain expression as a possible determinant of tumor aggressiveness in T1 colorectal carcinomas Dig Dis Sci 48 272–8 Occurrence Handle12643602

    PubMed  Google Scholar 

  18. T Masaki A Goto M Sugiyama et al. (2001) ArticleTitlePossible contribution of CD44 variant 6 and nuclear beta-catenin expression to the formation of budding tumor cells in patients with T1 colorectal carcinoma Cancer 92 2539–46 Occurrence Handle11745187

    PubMed  Google Scholar 

  19. T Masaki M Sugiyama H Matsuoka et al. (2003) ArticleTitleCoexpression of matrilysin and laminin-5 gamma2 chain may contribute to tumor cell migration in colorectal carcinomas Dig Dis Sci 48 1262–7 Occurrence Handle12870781

    PubMed  Google Scholar 

  20. I Sordat P Rousselle P Chaubert et al. (2000) ArticleTitleTumor cell budding and laminin-5 expression in colorectal carcinoma can be modulated by the tissue micro-environment Int J Cancer 88 708–17 Occurrence Handle11072238

    PubMed  Google Scholar 

  21. R Simon DG Altman (1994) ArticleTitleStatistical aspects of prognostic factor studies in oncology Br J Cancer 69 979–85 Occurrence Handle8198989

    PubMed  Google Scholar 

  22. T Okuyama M Oya M Yamaguchi (2002) ArticleTitleBudding (Sprouting) as a useful prognostic marker in colorectal mucinous carcinoma Jpn J Clin Oncol 32 412–6 Occurrence Handle12451038

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Dong-A University College of Medicine, Pusan, South Korea

    Ki-Jae Park M.D. & Hong-Jo Choi M.D.

  2. Department of Pathology, Dong-A University College of Medicine, Pusan, South Korea

    Mee-Sook Roh M.D.

  3. Department of Internal Medicine, Dong-A University College of Medicine, Pusan, South Korea

    Hyuk-Chan Kwon M.D.

  4. Department of Statistics, Pusan National University College of Natural Sciences, Pusan, South Korea

    Choongrak Kim Ph.D.

Authors
  1. Ki-Jae Park M.D.
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  2. Hong-Jo Choi M.D.
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Corresponding author

Correspondence to Hong-Jo Choi M.D..

Additional information

Dr. Choi was supported by the Dong-A University Research Fund in 2004, and Dr. Kim was supported by the Korea Science and Engineering Foundation Grant (R14-2003-002-01000-0).

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Park, KJ., Choi, HJ., Roh, MS. et al. Intensity of Tumor Budding and Its Prognostic Implications in Invasive Colon Carcinoma. Dis Colon Rectum 48, 1597–1602 (2005). https://doi.org/10.1007/s10350-005-0060-6

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  • DOI: https://doi.org/10.1007/s10350-005-0060-6

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