Tumour Budding and Survival in Stage II Colorectal Cancer: a Systematic Review and Pooled Analysis

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• 作者：F. Petrelli ; E. Pezzica ; M. Cabiddu ; A. Coinu…
• 关键词：Colorectal cancer ; Stage II ; Tumor budding ; Prognostic factor ; Overall survival ; Meta ; analysis
• 刊名：Journal of Gastrointestinal Cancer
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：46
• 期：3
• 页码：212-218
• 全文大小：286 KB
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• 作者单位：F. Petrelli (1)
  E. Pezzica (2)
  M. Cabiddu (1)
  A. Coinu (1)
  K. Borgonovo (1)
  M. Ghilardi (1)
  V. Lonati (1)
  D. Corti (2)
  S. Barni (1)
  
  1. Department of Oncology, Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy
  2. Department of Oncology, Division of Pathology, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy
  
• 刊物主题：Oncology; Gastroenterology; Radiotherapy; Cancer Research; Internal Medicine;
• 出版者：Springer US
• ISSN：1941-6636

文摘

Purpose Tumour budding is defined as the presence of isolated or small clusters of malignant cells at the invasive edge of the tumour. It is considered a negative prognostic factor in colorectal cancer (CRC) and is associated with a poor outcome and adverse pathological features. Here, we report a meta-analysis of the association of tumour budding and survival in stage II CRC patients. Methods PubMed, EMBASE, Web of Science and SCOPUS were searched for studies that assessed the relationship between tumour budding and 5-year overall survival (OS) in stage II CRC patients. Published data were extracted and used to compute odds ratios (ORs) for death at 5?years and hazard ratios (HRs) for survival amongst patients with respect to the extent of tumour budding, using multivariate analysis. Data were pooled using the Mantel–Haenszel random effect model. Results We analysed 12 studies that included a total of 1652 patients. High-grade budding was associated with worse OS at 5?years (OR for death, 6.25; 95?% confidence interval [CI], 4.04-.67; P-lt;-.00001). The absolute difference in 5-year OS was ?5?% (95?% CI, ?8–??-3?%, P-lt;-.00001). It was particularly noteworthy that the presence of high-grade budding was associated with an increased risk of death (HR for death, 3.68; 95?% CI, 2.16-.28, P-lt;-.00001). Conclusions Tumour budding is associated with worse survival in stage II CRC, in particular in pT3N0M0 patients. It could therefore potentially be used when deciding whether to administer adjuvant chemotherapy in high-risk node negative CRC patients.