Tumor budding as a prognostic factor for treatment outcomes in patients with stage 2 colon cancer

This study investigated the role of tumor budding (TB) in predicting the best treatment for stage 2 colon cancer. Researchers suggested that TB could improve the effect of chemotherapy after surgery in these patients.

Stage 2 colorectal cancer accounts for one-third of patients who undergo curative surgery. Prognostic factors help to decide on the best treatment after colon surgery.

TB consists of the presence of individual cells or small clusters of cells surrounding the tumor. As these cells may remain in the body after surgery, the risk of recurrence (when the cancer comes back) is higher. Prior studies showed that TB can be a good prognostic factor for patients with a high risk of recurrence. This will help to decide the best treatment after surgery for each patient.  However, it is not clear if patients with TB benefit from chemotherapy after surgery.

This study included 991 patients with stage 2 colon cancer. Off these, 376 patients had light TB, 331 had mild to severe TB and 284 had severe TB.

The 5-year recurrence-free rate (RFR; the percentage of patients without a recurrence 5 years after treatment) was 90.9% for the light group, 85.1% for the mild and 74.4% for the severe group. 

TB and cancer stage significantly impacted the RFR. Both mild and severe groups who received chemotherapy after surgery had a 5% improvement in the 5-year RFR when compared to surgery alone.

This study concluded that TB should be routinely tested and could improve the benefit of chemotherapy after surgery.

This study had a limited number of participants. Also, only one chemotherapy drug was used for the patients in this study. Further studies with a bigger population are necessary.