Tumour buds determine prognosis in resected pancreatic ductal adenocarcinoma

Abstract

Background The prognostic effect of tumour budding was retrospectively analysed in a cohort of 173 patients with resected pancreatic ductal adenocarcinomas (PDACs) of the prospective clinical multicentre CONKO-001 trial. Methods Haematoxylin and eosin (H&E)-stained whole tissue slides were evaluated. In two independent approaches, the mean number of tumour buds was analysed according to the consensus criteria in colorectal cancer, in one 0.785 mm 2 field of view and additionally in 10 high-power fields (HPF) (HPF = 0.238 mm 2 ). Results Tumour budding was significantly associated with a higher tumour grade ( p < 0.001) but not with distant or lymph node metastasis. Regardless of the quantification approach, an increased number of tumour buds was significantly associated with reduced disease-free survival (DFS) and overall survival (OS) (10 HPF approach DFS: HR = 1.056 (95% CI 1.022–1.092), p = 0.001; OS: HR = 1.052 (95% CI 1.018–1.087), p = 0.002; consensus method DFS: HR = 1.037 (95% CI 1.017–1.058), p < 0.001; OS: HR = 1.040 (95% CI 1.019–1.061), p < 0.001). Recently published cut-offs for tumour budding in colorectal cancer were prognostic in PDAC as well. Conclusions Tumour budding is prognostic in the CONKO-001 clinical cohort of patients. Further standardisation and validation in additional clinical cohorts are necessary.

Automated tumour budding quantification by machine learning augments TNM staging in muscle-invasive bladder cancer prognosis

“…Methods 1 and 2 were based on work by Karamitopoulou E et al 21 and Ueno H et al 32 and the recommendations of ITBCC 12 . Method 3 was inspired by Lohneis P et al 24 applying ten 0.238 mm 2 fields of view. Finally, Method 4-7 are novel approaches quantifying tumour buds across the whole slide or large regions of interest; methods only made feasible by the application of automated image analysis.…”

“…It has been suggested that TB reflects an early step in progression towards metastasis due to their cell's reported phenotypic epithelial to mesenchymal transition (EMT) [18][19][20] . Despite reports of observer variability, studies in other cancer types have continuously demonstrated the significant association of TB with adverse clinicopathological features and the independent significance of TB as a prognostic factor [21][22][23][24][25] . Information about the role of TB in bladder cancer is scarce 26 and it has not yet been reported to be associated with disease specific survival (DSS) in MIBC.…”

Hallmarks of cancer: Tumor budding as a sign of invasion and metastasis in head and neck cancer

“…2,8,9,11,12,20,27,34,40,45,48,54 This definition is in accordance with the recent recommendation by the International Tumor Budding Consensus Conference (ITBCC 2016) in colorectal cancer, 55 and also agrees with studies on other cancers. 56,57 Of note, a recent study has reported an excellent reproducibility and reliability of ITBCC 2016 scoring method in oral tongue cancer. 37 Majority of studies that assessing tumor budding in HNSCC have used one high-power field (HPF) in which the invasive front scanned and area with highest number of tumor budding is counted and used to score the case.…”

“…2,12,37,54,59 High reproducibility has also been shown in many studies evaluating tumor budding in other cancers. 57,[62][63][64] This indicates eligibility of tumor budding to be routinely implemented in clinical reports. Assessment of tumor budding using digital image analysis of pan-cytokeratin stained slides has recently shown a promising correlation with patient survival in oral cancer 25,65 and in colorectal cancer as well.…”

Identification of Immunological Features Enables Survival Prediction of Muscle-Invasive Bladder Cancer Patients Using Machine Learning

“…In particular, an increasing number of studies has shown the critical role of the immune contexture on patient survivability, suggesting that it could be a valuable determinant of patient prognosis [21,19]. Motivated by multiple papers [22,23,24,25], we investigate the prognostic role of tumour infiltrating lymphocytes (TILs), tumour-associated macrophages (TAMs), tumour buds (TBs), and programmed cell death-ligand 1 (PD-L1) in MIBC patients.…”