Prognostic significance of intra-tumoral budding in high-grade serous ovarian carcinomas

Toru Hachisuga,Taeko Ueda,Hiroshi Harada,Seiji Kagami,Midori Murakami,Ryosuke Tajiri,Masanori Hisaoka,Kiyoshi Yoshino,Tomoko Kurita

doi:10.1038/s41598-022-07269-2

Toru Hachisuga, Taeko Ueda + Show 7 more

Open Access

https://doi.org/10.1038/s41598-022-07269-2

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Abstract

Intra-tumoral budding (ITB) has been well demonstrated to be an independent risk factor for adverse outcomes in colorectal carcinoma. This study investigated the prognostic significance of ITB in high-grade serous ovarian carcinomas (HGSOCs). The medical records and slides of 84 SOCs, including 13 with neoadjuvant chemotherapy (NAC), were retrospectively reviewed. The histopathologic examination with scoring of p53 expression showed them to be 80 HGSOCs and 4 low-grade serous ovarian carcinomas (LGSOCs). ITB was found in 64 (80.0%) of the 80 HGSOCs and 1 (25.0%) of 4 LGSOCs. The presence of ITB in HGSOC was significantly correlated with a higher level of CA125, an advanced 2014 FIGO stage, the presence of Lymph node metastasis, and the presence of lymphovascular space invasion (LVSI). The median progression-free survival (PFS) was 18 months in patients with HGSOC with ITB and 36 months in patients with HGSOC without ITB (P = 0.006), and their median overall survival (OS) was 50 months and 60 months (P = 0.060). The multivariate analysis revealed that ITB was not an independent prognostic factor. ITB is a cost-effective prognostic indicator for patients with HGSOC and ITB in ovarian tumor tissue is considered a useful histological biomarker of the progression of HGSOCs.

Highlights

Intra-tumoral budding (ITB) has been well demonstrated to be an independent risk factor for adverse outcomes in colorectal carcinoma
When we examined the presence of ITB as a maker of destructive stromal invasion of serous ovarian carcinomas (SOCs), it was found to be a significant poor prognostic indicator for the progression-free survival (PFS) of patients with high-grade serous ovarian carcinomas (HGSOCs), but did not reach statistical significance for the overall survival (OS) of patients with HGSOC in the univariate analysis
The prognostic significance of ITB was considered to be strongly affected by the 2014 FIGO stage

Summary

Introduction

Intra-tumoral budding (ITB) has been well demonstrated to be an independent risk factor for adverse outcomes in colorectal carcinoma. ITB is a cost-effective prognostic indicator for patients with HGSOC and ITB in ovarian tumor tissue is considered a useful histological biomarker of the progression of HGSOCs. Many authors have examined the prognostic significance of histopathologic features for invasive ovarian carcinomas. Ovarian high- and low-grade serous carcinoma, was defined by Malpica et al.[3] in 2004 and subsequently adopted in the 2014 WHO Classification of Tumours of Female Reproductive Organs[4]. Variables Number of cases Age (years) median (range) Retroperitoneal lymph node sampling Platinum-based chemotherapy Neoadjuvant Adjuvant CA125 before initial treatment Median Range 2014 FIGO stage I and II III and IV Architectural grade 1 and 2 3 Nuclear grade 1 2 3 Mitoses* median (range) Lymphovascular space invasion Present Absent Lymph node metastasis Present Absent Intra-tumoral budding Present Absent Expression of p53 Over expression Complete absence Wild type

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