Anticancer research · 2025
Tumor Budding Grade and T Stage as Recurrence Predictors of High-risk Stage II Colorectal Cancer.
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Kodama Hiroyuki, Yamaguchi Toshifumi, Kameishi Shin, Kadono Toru, Yukami Hiroki, Hamamoto Hiroki, Lee Sang-Woong, Nishikawa Hiroki
Аннотация
BACKGROUND/AIM: High-risk features for recurrence in patients with pathological stage II colorectal cancer (pStage II-CRC) remain controversial. T4 stage (T4) is a strong prognostic factor. The SACURA trial showed that the high tumor budding group (BD3) had a significantly lower 5-year relapse-free survival (RFS) than the low and middle budding groups, although the BD3 group had a higher proportion of patients with T4. This study aimed to investigate the association between T4 and BD3 as a prognostic factor for pStage II-CRC.
PATIENTS AND METHODS: We retrospectively examined 448 consecutive patients with pStage II-CRC at our institution between January 2013 and March 2019. First, we identified prognostic factors affecting RFS among high-risk features, including: <12 lymph nodes examined, lymphatic, vascular, or perineural invasion, T4, BD3, and poorly differentiated/mucinous histology. Next, we compared 5-year RFS among three groups: patients with only BD3 (Group A), patients with only T4 (Group B), and patients with both T4 and BD3 (Group C).
RESULTS: The characteristics of the 448 patients were as follows: T4, 10%; BD3, 52%; <12 lymph nodes, 15%; poorly differentiated or mucinous adenocarcinoma, 6%; lymph/vascular/perineural invasion, 78/70/22%. The median follow-up duration was 63 months. Multivariate analysis identified T4 and BD3 as independent prognostic factors affecting RFS. The 5-year RFS in group C (23 patients: 55.3%) was significantly lower than those of groups A (215 patients: 84.0%) and B (20 patients: 73.7%) [A vs. C: hazard ratio (HR)=3.85, 95% confidence interval (CI)=1.95-7.62; B vs. C: HR=2.34, 95%CI=0.85-6.42, p=0.002].
CONCLUSION: Patients with high-risk pStage II-CRC who have T4 and BD3 factors have poor RFS.
PATIENTS AND METHODS: We retrospectively examined 448 consecutive patients with pStage II-CRC at our institution between January 2013 and March 2019. First, we identified prognostic factors affecting RFS among high-risk features, including: <12 lymph nodes examined, lymphatic, vascular, or perineural invasion, T4, BD3, and poorly differentiated/mucinous histology. Next, we compared 5-year RFS among three groups: patients with only BD3 (Group A), patients with only T4 (Group B), and patients with both T4 and BD3 (Group C).
RESULTS: The characteristics of the 448 patients were as follows: T4, 10%; BD3, 52%; <12 lymph nodes, 15%; poorly differentiated or mucinous adenocarcinoma, 6%; lymph/vascular/perineural invasion, 78/70/22%. The median follow-up duration was 63 months. Multivariate analysis identified T4 and BD3 as independent prognostic factors affecting RFS. The 5-year RFS in group C (23 patients: 55.3%) was significantly lower than those of groups A (215 patients: 84.0%) and B (20 patients: 73.7%) [A vs. C: hazard ratio (HR)=3.85, 95% confidence interval (CI)=1.95-7.62; B vs. C: HR=2.34, 95%CI=0.85-6.42, p=0.002].
CONCLUSION: Patients with high-risk pStage II-CRC who have T4 and BD3 factors have poor RFS.