Tumor budding as a prognostic predictive factor in colorectal cancer

This study investigated the impact of tumor budding (when surrounding the tumor there are tumor cells released from the main tumor that can spread to other places in the body) in colorectal cancer. Researchers suggested that tumor budding is predictive of lymph node metastasis (spread to the lymph nodes), recurrence (when the cancer comes back) and cancer-related death at 5 years.

Tumor budding has been associated with a worse prognosis in colorectal cancer. Budding is a strong predictive factor for lymph node metastasis, recurrence and overall survival. Additionally, an association with metastasis in other organs has also been reported. Tumor budding could be a strong predictive factor to include in clinical practice to better determine prognosis and plan the treatment. However, it is still difficult to choose an adequate method to determine tumor budding for all cancer stages. Its’ usefulness in the staging of colorectal cancer has not yet been agreed on.

The objective of this study was to determine the impact of tumor budding in lymph node metastasis, recurrence and cancer-related death in operable colorectal cancer. This study examined 34 other studies including 7821 operable colorectal cancer patients.

25 studies compared the rate of tumor budding to lymph node metastasis. Patients with budding were 4.9 times more at risk of lymph node metastasis.

12 studies compared the rate of tumor budding with recurrence. Patients with budding were 5.5 times more at risk of recurrence.

The rate of tumor budding and the 5-year overall survival was reported in 9 studies. Patients with budding were 4.5 times more at risk of cancer-related death at 5 years.

This study showed that tumor budding is associated with higher rates of lymph nodes metastasis, recurrence and cancer-related death. The authors suggested that including tumor budding in the staging of disease would improve the choice of treatment plan.