Abstract 6133: Intratumoral budding in pretreatment biopsies can predict prognosis and neoadjuvant therapy response among the tumor microenvironmental components in colorectal adenocarcinoma

Abstract

Abstract Purpose: Neoadjuvant therapy has been used as one of a treatment option in locally advanced rectal cancer and unresectable colorectal cancers (CRCC) with oligo-metastasis. Considering that radical specimen has been deformed due to this treatment, predicting prognosis is more complex. We evaluated several tumor microenvironmental factors in the pretreatment biopsies; those were known as prognostic factors in radical specimen. Methods: From 2010 to 2021, 85 patients with neoadjuvant therapy and surgery for CRCC were enrolled in Uijeongbu St. Mary’s hospital. Intratumoral budding (ITB), tumor stromal ratio, presence of immature stroma and Klintruo-Makinen grade for inflammatory cells were evaluated in pretreatment biopsies by three pathologists, independently. Results: Only high grade ITB (OS: p = 0.030, CSS: p = 0.005, DFS: p < 0.001) was poor survival factor in univariate analysis. In addition, high grade ITB was related with pathological stage (p = 0.017), lymphatic invasion (p = 0.010) and chemoresistance in non-metastatic CRCC group (p = 0.046). Presence of immature fibrosis was related with clinical stage (p = 0.045) and pathological stage (p = 0.033). In multivariate analysis, high grade ITB was independent poor survival factor (OS: p = 0.031, CSS: p = 0.009, DFS: p = 0.001). Conclusion: Our study revealed that high grade ITB in pretreatment biopsied was poor survival factor in CRCC with neoadjuvant treatment. In our observation, we recommend that ITB result should be included in the pathology report when considering neoadjuvant treatment. Citation Format: Kwangil Yim, Won Mo Jang, Yosep Chong, OK Ran Shin, Kyung Jin Seo. Intratumoral budding in pretreatment biopsies can predict prognosis and neoadjuvant therapy response among the tumor microenvironmental components in colorectal adenocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6133.