Tumour budding : an emerging prognostic factor in colorectal carcinoma

Tumour budding, is a morphological feature seen in colorectal carcinoma and known to be associated with a poor outcome. It is thought to be representing the phenomenon of epithelial-mesenchymal transition of colorectal carcinoma. Colorectal malignancies exhibiting budding have shown an association with lymphatic invasion and lymph node metastasis. In addition, tumour budding has proven to be associated with tumour recurrence and is a negative prognostic indicator of overall survival of patients with colorectal carcinoma.

Objectives of the study was to assess the prevalence of tumour budding in CRC (higher colorectal carcinoma) specimens and to determine the association between tumour budding and the histological grade, nodal involvement and tumour recurrence.

A retrospective study was carried out at the Department of Pathology, Faculty of Medical Sciences, University of Sri Jayewardenepura. The study sample included 58 cases of colorectal carcinoma during the period January 2015 to June 2018. The histological grade, nodal status and tumour recurrence was recorded following review of histology slides. In addition, the slides were examined for the presence or absence of tumour budding, according to the ITBCC (November 2016) recommendations.

Study population showed a tumour budding percentage of 32.75%. Tumour budding in colorectal carcinoma showed a statistically significant association with high histological grade, lymph nodal involvement and tumour recurrence (p-value < 0.05).

Tumour budding in CRC is strongly predictive of high histological grade, lymph node metastases, and tumour recurrence. The study population included 02 cases of tumour recurrence in the budding group and a single case of cancer-related deaths.