Abstract
PurposeTumour budding (TB) is an important adverse prognostic factor in colon cancer, which can also guide adjuvant treatment in stage II colorectal carcinoma. The International Tumor Budding Consensus Conference (ITBCC) recommended a three-tiered scoring system to streamline the scoring of budding across the globe. The goal of this survey is to understand the variation in reporting practice, globally.MethodsA short survey was designed as an online questionnaire and shared via social media platforms and emails to pathology society groups in various countries.ResultsA majority of the 294 respondents (186/294; 63.3%) report budding in colorectal carcinoma. This figure differed significantly from 53.4% in Asia to 97.4% in North America. The most common (56.4%) reason for not reporting TB was because it is yet not a mandatory recommendation in the various datasets (e.g. The College of American Pathologists). The majority (78.9%) of the people who were reporting TB, used the ITBCC scoring system (scoring on a single hotspot 20× field). Most used 10× objective for screening (88.7%) and scored only at the invasive front (88.7%). Immunohistochemistry (8.6%) or deeper cuts (24.2%) were rarely used. TB scoring took 10 minutes or less in most (87.1%).ConclusionThough budding is well accepted among specialist gastrointestinal pathologists, it is still not universally accepted as an important prognostic parameter across the globe. The hesitancy for reporting is due to a combination of lack of clinical demand and extra effort and time involved in counting the ITBCC score.
Highlights
To the authors’ knowledge, this is the first survey looking at reporting practices of Tumour budding (TB) internationally
The lack of easy availability of 20× high power objectives in resource-constrained settings is a valid limitation to adopting the International Tumor Budding Consensus Conference (ITBCC) scoring system
The experience of the pathologist and familiarity with the concept of TB was not captured in this survey and we cannot determine if this had an impact on reporting patterns
Summary
A short survey was designed as an online questionnaire and shared via social media platforms and emails to pathology society groups in various countries. The survey was designed as an online questionnaire using a free form creation app (Google Forms). There were 13 questions that covered the elements of practice (geography, academic or service, specialist or generalist), reasons for or against reporting TB, the methods used, the time spent and the perceived clinical relevance in routine practice. The link was shared via social media platforms and emails through various pathology societies and groups
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