Prognostic Significance of Tumor Budding in Urothelial Carcinomas of the Bladder: Comparison of Two Different Tumor Budding Evaluation Methods

Abstract

Aim: In our study, we aimed to reveal the effect of tumor budding(TB) on prognosis in urothelial carcinomas and to compare the most commonly used alternative method (AM) and the International Tumor Budding Consensus Conference (ITBCC) system. TB can be easily assessed on routine hematoxylin and eosin-stained slides. In studies, TB was found to be associated with prognostic parameters in many organs. TB assessment in many organ cancers is based on ITBCC or alternatively different values used by different authors. 
 Material and Method: Forty-eight urothelial cancers were obtained from 2010 to 2016 that was comprised of those having undergone surgical staging with a cystectomy or cystoprostatectomy and at least 5 years followed up. All hematoxylin and eosin-stained slides were re-evaluated for the status of TB according to ITBCC and AM.
 Results: According to ITBCC TB was not correlated with pT, lymphovascular invasion, lymph node involvement (LNI), tumor stage and 5-year mortality (p=0.102, p=0.722, p=0.165, p=0.431, p=0.524). According to AM, TB was more frequent as pT advanced, and was marginally associated with LNI (p=0.027, p=0.058). There was no relationship between TB and overall survival (p=0.130).
 Conclusion: We found the cut-off value in AM more useful than ITBCC recommendations. Although the association of TB with some of the prognostic parameters suggests that it may also be associated with prognosis, no relationship was found with overall survival. This may be related to the number of our cases.