Abstract
BackgroundThe 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.MethodsHaematoxylin 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 mm2 field of view and additionally in 10 high-power fields (HPF) (HPF = 0.238 mm2).ResultsTumour 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.ConclusionsTumour budding is prognostic in the CONKO-001 clinical cohort of patients. Further standardisation and validation in additional clinical cohorts are necessary.
Highlights
The clinical outcome of pancreatic ductal adenocarcinoma (PDAC) is determined by the invasive spread of tumour cells in the adjacent tissue, as well as into regional lymph node
Tumour budding is best described as a certain type of invasive growth pattern, often but not exclusively present at the invasion front, that is observed at histological examination of carcinomas
We studied the prognostic effect of tumour buds in a cohort of 173 PDACs from the clinical multicentre CONKO-001 trial
Summary
The clinical outcome of pancreatic ductal adenocarcinoma (PDAC) is determined by the invasive spread of tumour cells in the adjacent tissue, as well as into regional lymph node. Tumour budding is best described as a certain type of invasive growth pattern, often but not exclusively present at the invasion front, that is observed at histological examination of carcinomas It is defined as isolated tumour cells or small nonglandular tumour cell cluster and commonly believed to represent epithelial–mesenchymal transition (EMT) of tumours.[1, 2] EMT describes a process of cell-plasticity, in which cells loose epithelial and gain mesenchymal characteristics. We studied the prognostic effect of tumour buds in a cohort of 173 PDACs from the clinical multicentre CONKO-001 trial. 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. Further standardisation and validation in additional clinical cohorts are necessary
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