Tumor budding is an adverse prognostic marker in intestinal-type sinonasal adenocarcinoma and seems to be unrelated to epithelial-mesenchymal transition

Maffeis, Valeria; Cappellesso, Rocco; Galuppini, Francesca; Guzzardo, Vincenza; Zanon, Antonio; Cazzador, Diego; Emanuelli, Enzo; Ventura, Laura; Fassina, Ambrogio

doi:10.1007/s00428-020-02748-1

Cited by 10 publications

(22 citation statements)

References 45 publications

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“…As a consequence of this resemblance, TB, a widely accepted concept in CRC, has recently been adapted for ITAC [ 42 ]. Tumor budding is to understand as a morphological feature defined as single cells or small cell clusters, so called tumor buds, constituting up to four cells at the invasive front of the tumor or within the tumor mass [ 21 , 43 ]. For CRC, TB is known to be associated with high and advanced tumor stage, lymphatic and vascular invasion, nodal and distant metastasis and worsening of OS, DFS and recurrence free survival.…”

Section: Discussionmentioning

confidence: 99%

“…From a prognostic point of view, an advanced tumor stage, sphenoid sinus involvement, orbital, dural or brain infiltration and high-grade histology were established as prognostic factors of poor outcome [7,[11][12][13][14]. Recently, tumor budding (TB), a known risk factor in particular for colorectal carcinoma (CRC), but also certain head and neck cancer subtypes [13,[15][16][17][18][19][20], has been discussed as negative prognostic factor in ITAC [21]. This hypothesis is particularly interesting, since ITAC morphologically, immuno-phenotypically and in part molecularly show a substantial resemblance to CRC [22,23].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, tumor budding (TB), a known risk factor in particular for colorectal carcinoma (CRC), but also certain head and neck cancer subtypes [ 13 , 15 – 20 ], has been discussed as negative prognostic factor in ITAC [ 21 ]. This hypothesis is particularly interesting, since ITAC morphologically, immuno-phenotypically and in part molecularly show a substantial resemblance to CRC [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Reappraisal of Grading in Intestinal-Type Sinonasal Adenocarcinoma: Tumor Budding as an Independent Prognostic Parameter

Meerwein

Brada

Soyka

et al. 2022

Head and Neck Pathol

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Since sinonasal intestinal-type adenocarcinomas (ITAC) show resemblance to colorectal adenocarcinomas, we aimed to investigate novel prognostic factors of outcome, with particular focus on the role of tumor budding (TB). Retrospective clinico-pathological single-institution study on consecutive ITAC patients between 1996 and 2020. Histopathological parameters including conventional subtypes and TB features (low, intermediate, high) were evaluated with the aid of pancytokeratin (AE1/AE3) immunohistochemical staining. Parameters were correlated to clinical data and outcome. A total of 31 ITAC patients were included. Overall, 19/31 patients (61.3%) presented with stage III/IV disease. Presence of lymph node or distant metastases was rare (1/31 patient, 3.2%). Treatment protocols consisted of tumor resection in 30/31 patients (96.8%) and primary radiochemotherapy in 1/31 patient (3.2%). Adjuvant radiation therapy was conducted in 20/30 surgically treated patients (66.7%). The 3- and 5-year overall survival (OS) was 83.9% and 78.3% and the 3- and 5-years disease-specific survival (DSS) 83.7% % and 78.5%, respectively. The presence of intermediate/high TB (defined as ≥ 5 buds) was associated with both, worse DSS (log rank p = 0.03) and OS (log rank p = 0.006). No patient with low TB revealed progressive disease or died of the disease. No association between TB and tumor stage or conventional tumor subtype was found. Tumor budding seems to be an independent prognostic factor of worse outcome in ITAC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reappraisal of Grading in Intestinal-Type Sinonasal Adenocarcinoma: Tumor Budding as an Independent Prognostic Parameter

Meerwein

Brada

Soyka

et al. 2022

Head and Neck Pathol

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“…7.2c). There is evidence that tumors pertaining to the same histological category can display widely different propensity to grow beyond the macroscopic boundaries of the lesion through budding, satellitosis, pagetoid growth, perineural spread, permeative bone invasion, or other mechanisms [14][15][16][17][18][19][20][21]. This fact poses an additional challenge, since a tumor, even though labelled with a reliable preoperative diagnosis, might potentially be amenable to a "close-margin" excision (i.e., when microscopic local extension is limited) or could instead require a "wide-margin" resection (i.e., when microscopic groups of cells deeply invade adjacent tissues) as far as is known prior to surgery.…”

Section: Special Elements Of Challenge In the Head And Neck Areamentioning

confidence: 99%

Novel Approaches in Surgical Management: How to Assess Surgical Margins

Ferrari

Montalto

Nicolai

2021

Critical Issues in Head and Neck Oncology

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The concept of surgical margins was born a long time ago but still lacks a univocal and sound understanding. The current biological rationale behind the recommendations on margins management relies on two pillars: (1) the observation that groups of cancer cells can leave the macroscopic tumor and disseminate throughout adjacent tissues with different degrees of aggressiveness; (2) the belief that removal of all (or most of) cancer cells can cure the patient. However, this background is undermined by some pieces of evidence. For instance, it has been proven that tissues surrounding cancer often bear precancerous traits, which means that cutting through non-cancerous tissues does not equate to cut through healthy tissues. The head and neck exquisitely poses a number of challenges in the achievement of negative margins, with special reference to anatomical complexity, high density in relevant structures, and unique histological heterogeneity of cancers. Currently, intraoperative margins evaluation relies on surgeons’ sight, palpation, ability to map tumor extension on imaging, and knowledge of anatomy, with some optical imaging technologies aiding the delineation of the mucosal margins of excision. Frozen sections are currently used to intraoperatively evaluate margins, yet with debate on whether and how this practice should be performed. Future perspectives on improvement of margins control are threefold: research is oriented towards refinements of understanding of cancers local progression, implementation of technologies to intraoperatively render tumor extension, and employment of optical imaging modalities capable of detecting foci of residual tumor in the surgical bed.

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“…1 ). Twelve records in 9 studies [ 9 , 11 , 12 , 17 , 19 , 22 , 23 , 34 , 35 ] provided tumor stage. Figure 2 displays the distribution of the 12 records of T3 or T4 stage versus enrollment year.…”

Section: Resultsmentioning

confidence: 99%

Decreasing recurrence and increasing survival rates in patients of ethmoid or sphenoid intestinal-type adenocarcinomas

Huang

Tsai

et al. 2021

Medicine

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Background: Ethmoid or sphenoid intestinal-type adenocarcinomas (ITACs) form a distinct subtype of sinonasal adenocarcinomas that occur less than 1 case/100,000/yr. They have obvious exposure relationship to hardwood or leather dusts, infrequent metastasis, but a relatively high local-recurrence rate. They locate at sinuses close to vital structures listed as high-risk areas in surgeries. Even in expert hands, a craniofacial resection is associated with non-negligible mortality and morbidity. Management of these tumors, first or recurrent, needs to weigh these consequences versus the survival, regional-recurrence, and distant-recurrence rates. Due to the rareness of ethmoid or sphenoid ITACs, accurate overall survival and local- or regional-recurrence rates across diverse treatments are unclear. The aim of this study is to report the overall statistics of this cancer and the relationship between enrollment year versus age, recurrence, and survival. Methods: Systemic review and meta-analysis with 1126 cases across various treatments in the literature. Results: Here, we show that patients of ethmoid or sphenoid ITACs had overall local-, regional-, and distant-recurrence rates of 32.2%, 2.2%, and 10.3%, respectively, with a 5-year overall survival rate of 66.2%. The results present a significant correlation between age, local-recurrent rate, or overall survival rate versus enrollment year. Conclusion: This suggests that recent patients of ethmoid or sphenoid ITACs may present at an older mean age, have a lower local-recurrence rate, and have a better 5-year survival rate than before. There was a shifting trend of treating ethmoid ITACs from external approach to endoscopic resection. Clinicians may want to weigh mortality and morbidity rates of external surgeries and these data to share or decide a solution.

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Tumor budding is an adverse prognostic marker in intestinal-type sinonasal adenocarcinoma and seems to be unrelated to epithelial-mesenchymal transition

Cited by 10 publications

References 45 publications

Reappraisal of Grading in Intestinal-Type Sinonasal Adenocarcinoma: Tumor Budding as an Independent Prognostic Parameter

Reappraisal of Grading in Intestinal-Type Sinonasal Adenocarcinoma: Tumor Budding as an Independent Prognostic Parameter

Novel Approaches in Surgical Management: How to Assess Surgical Margins

Decreasing recurrence and increasing survival rates in patients of ethmoid or sphenoid intestinal-type adenocarcinomas

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