405 Tumor Budding as a Prognostic Marker for Esophageal Squamous Cell Carcinoma

Abstract

Carcinomas of the esophagus are the sixth most common malignancy worldwide in males. Esophageal cancer occurs in two histological types: SCC and adenocarcinoma, 90% is SCC in developing countries. The presence of tumor budding (TB) at the tumor–host interface of gastrointestinal cancers has been recognized as a hallmark of unfavorable disease biology. TB is defined as the presence of isolated malignant cells or small clusters of up to five cells at the tumor invasive front. Methods The study done by taking formalin fixed paraffin blocks of 13 esophagectomy specimens from the year 2014-2019. TB score was calculated at the invasive front of the tumor in 200x magnification. 10 fileds were screened and a hotspot was found. <5 buds were taken as a low grade budding. ≥5 buds were taken as a high grade budding. Results The study showed that 53.85% were found to be males & 46.15% were females. In pT staging, T3 was the most common. 61.5% of the cases showed high grade budding while low grade budding was seen in only 38.5%. This tells us 69.2% fell under T3 stage of which 88.89% had high grade TB while only 11.11% had low grade budding. Of the 4 present cases of LVI, 75% had high grade TB & 25% had low grade budding. Of the 3 margin involved cases, 67% had high grade TB while 33% had low grade budding. Conclusion To conclude, TB is a valuable prognostic factor and indicator of aggressive diseases. Presence of TB correlates to unfavorable clinico-pathological features. It also provides an important value of risk stratification. 1. Risk stratification 2. High grade TB benefit from esophagectomy.