Tumour budding in preoperative biopsy specimens is a useful prognostic index for identifying high-risk patients in early-stage pN0 colon cancer

Abstract

Background/aim: Tumour budding BD is considered a valuable prognostic factor in colon cancer CC , but its use in daily practice is uncertain. We investigated the prognostic effect of BD using preoperative biopsy specimens in a fairly homogeneous population. Materials and methods: Eighty-two pN0 CC patients who underwent surgery after preoperative biopsy between 1997 and 2013 were included in the study. Model A using the `deeply invasive blocks & hot-spot area & invasive margin and method 1 using the `20× objective & immunohistochemistry staining & quantitive counting' were used as standard methods. Results: High BD was significantly associated with poor prognostic factors lymphatic invasion [P = 0.008], perineural invasion [P = 0.041], advanced pT [P = 0.015], invasive margin [P = 0.008], and margin involvement [P = 0.019] . Moreover, correlations between different BD estimates r = 0.613-0.696 , reproducibility of study Kappa = 0.68-0.73 , and usefulness of cut-off value area of under ROC = 0.746 [0.663-0.829] were well. In univariate analysis, 5-year survival was poor in patients with high BD relaps-free survival [RFS]: 71 %, P