Tumor budding in upper urinary tract urothelial carcinoma: a putative prognostic factor for extraurothelial recurrence and overall survival

Kawamura, Kazuki; Miyai, Kosuke; Asakuma, Junichi; Sato, Kimiya; Matsukuma, Susumu; Tsuda, Hitoshi; Ito, Keiichi

doi:10.1007/s00428-020-02989-0

Cited by 10 publications

(8 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tumor budding has rarely been studied in upper urinary tract urothelial carcinoma (UUTUC). Kawamura et al investigated 135 invasive UUTUCs, in which high tumor budding correlated to the pT stage, lymphovascular invasion, and lymph node metastasis, and confirmed that tumor budding is associated with poor prognosis of UUTUCs [26]. The cell nest size especially a smaller cell nest size is the second histological feature that predicts clinical biological behavior of tumor aggressiveness.…”

Section: Discussionmentioning

confidence: 96%

A Novel Prognostic Stratified System Based on Tumor Budding and the Cell Nest Size in Ureter Urothelial Carcinoma

Yang

2022

Applied Bionics and Biomechanics

View full text Add to dashboard Cite

At present, malignant tumor stratification based on the TNM stage is very important for predicting patient prognosis and selecting appropriate treatment. The prognostic factor of ureter urothelial carcinoma is mainly based on the stage according to AJCC (8th) TNM classification. None of the histomorphologic features is recommended to assess patient’s prognosis. Recently, a novel three-tiered grading system based on tumor budding and the cell nest size (referred as TBNS system) has been applied to be highly prognostic for some squamous cell carcinomas, including esophageal, pulmonary, uterine cervix cancer, and endocervical endocarcinoma. In this study, we explored the application of this TBNS grading system in ureter urothelial carcinoma consisting 87 surgically resected cases and no neoadjuvant therapy. Tumor budding and the cell nest size were assessed and correlated with clinicopathological data and survival. The results showed that higher tumor budding, cell nest size, and TBNS grading system were strongly related to shorter overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). Multivariate survival analysis showed the TBNS grading system to be closely related to the independent prognosis of DFS and DSS. In conclusion, the TBNS grading system based on tumor budding and cell nest size, if further validated, could satisfactorily predict the prognosis of uterine urothelial carcinoma and be applicable in routine pathologic description of this cancer type.

show abstract

Section: Discussionmentioning

confidence: 96%

A Novel Prognostic Stratified System Based on Tumor Budding and the Cell Nest Size in Ureter Urothelial Carcinoma

Yang

2022

Applied Bionics and Biomechanics

View full text Add to dashboard Cite

show abstract

“…Although tumor budding can be assessed only on H&E-stained slides, it has been indicated that accurate and reproducible determination has been difficult, particularly in terms of the identification of single cancer cells and small cell clusters [ 38 ]. In addition, some anatomical characteristics of the upper urinary tract, such as renal tubules and collecting ducts in the renal parenchyma, occasionally obscure invasive cancer cells [ 7 ], whereas the peritumoral stroma is insusceptible to this matter. Although further investigation is necessary, high stromal periostin expression on immunohistochemistry can be a useful prognostic marker for UTUCs.…”

Section: Discussionmentioning

confidence: 99%

“…For example, renal pelvic cancers invading peripelvic adipose tissue or renal parenchyma (from microscopic minimal to macroscopic deep invasion) are categorized as pT3 and show highly variable clinical courses [ 5 , 6 ]. We previously demonstrated that tumor budding, defined as a single cancer cell or clusters of fewer than five cancer cells at the tumor invasion front, is a possible prognostic factor independent of the stage and grade of invasive UTUCs [ 7 ]. Considering tumor invasiveness, much attention has been focused on the interaction between cancer cells and the tumor microenvironment [ 8 , 9 ]; however, the molecular mechanism in UTUCs is not widely understood.…”

Section: Introductionmentioning

confidence: 99%

Prognostic impact of stromal periostin expression in upper urinary tract urothelial carcinoma

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Periostin is an extracellular matrix protein that has been known to be implicated in fibrillogenesis and cell migration, including cancer metastasis. Periostin overexpression in cancer cells and/or intervening stroma is usually related to tumor progression and poor patient outcomes in various human cancers; however, its role in urothelial carcinoma, especially upper urinary tract urothelial carcinomas (UTUCs), remains inconclusive. Methods Samples from 126 consecutive cases of invasive UTUC (69 renal pelvic cancers and 57 ureteral cancers) were histologically reviewed and analyzed for periostin expression using immunohistochemistry. The intensities of immunoreactivity and the fraction of positive cancer cells and stroma (i.e., epithelial and stromal expression, respectively) were classified into four categories each (intensity, 0–3; fraction, 0–25% = 1; 26–50% = 2; 51–75% = 3; and > 75% = 4). The overall score was determined by multiplying both scores, and overall scores ≥ 6 were considered to indicate high periostin expression. Results Among 126 UTUCs, 55 (44%; 27 renal pelvic and 28 ureteral cancers) showed high stromal periostin expression. None of the cases were considered to have high epithelial periostin expression. High stromal periostin expression was associated with non-papillary gross findings, higher pathological T category, lymphovascular invasion, concomitant carcinoma in situ, subtype histology, lymph node metastasis, positive surgical margins, high tumor budding, and high tumor-associated immune cell status. Multivariate analysis revealed that high stromal periostin expression was an independent predictor of overall survival (p = 0.00072, hazard ratio = 3.62), and lymphovascular invasion and high stromal periostin expression were independent predictors of cancer-specific survival (p = 0.032 and 0.020, hazard ratio = 2.61 and 3.07, respectively). Conclusions Stromal periostin expression was often observed in invasive UTUCs with adverse clinicopathological factors and may be a useful predictor of patient outcomes.

show abstract

“…For example, tumor budding is divided into two grades in head and neck, oral, and cervical cancers (11)(12)(13) [low grade of budding (0-5 buds) and high grade of budding (more than 5 buds)]. In upper urothelial carcinoma and pancreatic ductal adenocarcinoma (14,15), less than 10 buds is considered low grade of budding, while more than 10 buds is considered high grade. In colon cancer, Zlobec et al (16) found that there was a significant difference when BD0(0 buds) was compared statistically to BD1 (1-4 buds) for pT, TNM, tumor grade, and lymphatic, venous, and perineural invasion (p < 0.01, all).…”

Section: Overviewmentioning

confidence: 99%

“…For example, tumor budding is divided into two grades in head and neck, oral, and cervical cancers ( 11 – 13 ) [low grade of budding (0-5 buds) and high grade of budding (more than 5 buds)]. In upper urothelial carcinoma and pancreatic ductal adenocarcinoma ( 14 , 15 ), less than 10 buds is considered low grade of budding, while more than 10 buds is considered high grade. In colon cancer, Zlobec et al.…”

Section: Overviewmentioning

confidence: 99%

Tumor budding as a predictor for prognosis and therapeutic response in gastric cancer: A mini review

Xue

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

In recent years, the role of tumor budding in gastric cancer has received increased attention across a number of disciplines. Several studies have found associations between tumor budding and the prediction of lymph node metastasis in early gastric cancer, prognosis of advanced gastric cancer, predictors of therapeutic response to immune checkpoint inhibitors, such as microsatellite instability (MSI), and therapeutic targets of molecular targeted therapy, such as human epidermal growth factor receptor 2 (HER-2). Therefore, tumor budding is a major element in the formulation of risk stratification and precision medicine strategies for patients with gastric cancer.

show abstract

Tumor budding in upper urinary tract urothelial carcinoma: a putative prognostic factor for extraurothelial recurrence and overall survival

Cited by 10 publications

References 29 publications

A Novel Prognostic Stratified System Based on Tumor Budding and the Cell Nest Size in Ureter Urothelial Carcinoma

A Novel Prognostic Stratified System Based on Tumor Budding and the Cell Nest Size in Ureter Urothelial Carcinoma

Prognostic impact of stromal periostin expression in upper urinary tract urothelial carcinoma

Tumor budding as a predictor for prognosis and therapeutic response in gastric cancer: A mini review

Contact Info

Product

Resources

About