The potential predictive value of tumor budding for neoadjuvant chemoradiotherapy response in locally advanced rectal cancer

• Published in: Strahlentherapie und Onkologie 2018-11, Vol.194 (11), p.991-1006
• Main Authors: Jäger, Tarkan, Neureiter, Daniel, Fallaha, Mohammad, Schredl, Philipp, Kiesslich, Tobias, Urbas, Romana, Klieser, Eckhard, Holzinger, Josef, Sedlmayer, Felix, Emmanuel, Klaus, Dinnewitzer, Adam
• Format: Article
• Language: English
• Subjects: Aged; Cancer; Cell Transformation, Neoplastic - pathology; Chemoradiotherapy; Chemotherapy; Colorectal cancer; Combined Modality Therapy; Confidence intervals; Epithelial-Mesenchymal Transition - physiology; Female; Hazards; Health risk assessment; Humans; Kaplan-Meier Estimate; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - therapy; Neoplasm Staging; Oncology; Original; Original Article; Patients; Proportional Hazards Models; Prospective Studies; Radiation therapy; Radiotherapy; Rank tests; Rectal Neoplasms - mortality; Rectal Neoplasms - pathology; Rectal Neoplasms - therapy; Regression analysis; Statistical analysis; Survival; Tumor Microenvironment - physiology; Tumors
• ISSN: 0179-7158; 1439-099X
• DOI: 10.1007/s00066-018-1340-0

Purpose This study was conducted to investigate the potential predictive value of tumor budding for neoadjuvant chemoradiotherapy response in locally advanced rectal cancer. Patients and methods Surgical specimens of 128 ypUICC (Union for International Cancer Control) stage 0–III mid-to-low rectal cancer patients were identified from a prospectively maintained colorectal cancer database and classified into two groups using the 10 high-power field average method: none/mild tumor budding (BD-0) and moderate/severe tumor budding (BD-1). Overall survival, relapse-free survival (RFS), and recurrence estimates were calculated using the Kaplan–Meier method and compared with the log-rank test. For RFS, a multivariable Cox’s proportional hazards regression analysis was performed. Results No ( n  = 20) or mild ( n  = 27) tumor budding (BD-0) was identified in 47 (37%) and moderate ( n  = 52) or severe ( n  = 29) tumor budding (BD-1) in 81 (63%) surgical specimens. Positive tumor budding (BD-1) was associated with significantly reduced T‑level downstaging ( P