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Published in: Strahlentherapie und Onkologie 11/2018

Open Access 01-11-2018 | Original Article

The potential predictive value of tumor budding for neoadjuvant chemoradiotherapy response in locally advanced rectal cancer

Authors: Tarkan Jäger, Daniel Neureiter, Mohammad Fallaha, Philipp Schredl, Tobias Kiesslich, Romana Urbas, Eckhard Klieser, Josef Holzinger, Felix Sedlmayer, Klaus Emmanuel, Adam Dinnewitzer

Published in: Strahlentherapie und Onkologie | Issue 11/2018

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Abstract

Purpose

This study was conducted to investigate the potential predictive value of tumor budding for neoadjuvant chemoradiotherapy response in locally advanced rectal cancer.

Patients and methods

Surgical specimens of 128 ypUICC (Union for International Cancer Control) stage 0–III mid-to-low rectal cancer patients were identified from a prospectively maintained colorectal cancer database and classified into two groups using the 10 high-power field average method: none/mild tumor budding (BD-0) and moderate/severe tumor budding (BD-1). Overall survival, relapse-free survival (RFS), and recurrence estimates were calculated using the Kaplan–Meier method and compared with the log-rank test. For RFS, a multivariable Cox’s proportional hazards regression analysis was performed.

Results

No (n = 20) or mild (n = 27) tumor budding (BD-0) was identified in 47 (37%) and moderate (n = 52) or severe (n = 29) tumor budding (BD-1) in 81 (63%) surgical specimens. Positive tumor budding (BD-1) was associated with significantly reduced T‑level downstaging (P < 0.001) and tumor regression (P < 0.001). After a median follow-up time of 7 years (range 2.9–146.7 months), BD-0 patients had more favorable 5‑year RFS (90 vs. 71%, P = 0.02) and distant recurrence (2 vs. 12%, P = 0.03) estimates. Multivariable analyses confirmed BD-1 as a negative predictive parameter for RFS (hazard ratio = 3.44, 95% confidence interval 1.23–9.63, P = 0.018).

Conclusions

Our data confirm tumor budding as a strong prognostic factor and its potential predictive value for neoadjuvant chemoradiotherapy response in locally advanced rectal cancer patients. This provides the opportunity to modify and individualize neoadjuvant therapy regimens for non-responders.
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Metadata
Title
The potential predictive value of tumor budding for neoadjuvant chemoradiotherapy response in locally advanced rectal cancer
Authors
Tarkan Jäger
Daniel Neureiter
Mohammad Fallaha
Philipp Schredl
Tobias Kiesslich
Romana Urbas
Eckhard Klieser
Josef Holzinger
Felix Sedlmayer
Klaus Emmanuel
Adam Dinnewitzer
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 11/2018
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-018-1340-0

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