Prospective Multicenter Study on the Prognostic and Predictive Impact of Tumor Budding in Stage II Colon Cancer: Results From the SACURA Trial

Autor: Satoshi Teramukai, Hideki Ueno, Seiichi Shinji, Kenichi Sugihara, Kenta Murotani, Hiroyuki Uetake, Megumi Ishiguro, Tomohisa Egawa, Yoshihiko Nakamoto, Osamu Ikawa, Shigeyuki Matsui, Keigo Yasumasa, Toshiaki Ishikawa, Masanori Kotake, Kohei Murata, Chu Matsuda, Naohiro Tomita, Kiyotaka Kurachi, Eiji Nakatani
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Oncology
Male
Cancer Research
medicine.medical_specialty
Epithelial-Mesenchymal Transition
medicine.medical_treatment
Disease-Free Survival
law.invention
03 medical and health sciences
0302 clinical medicine
Tumor budding
Randomized controlled trial
law
Predictive Value of Tests
Internal medicine
Gastrointestinal Cancer
Medicine
Humans
Prospective Studies
Prospective cohort study
Uracil
Aged
Neoplasm Staging
Proportional Hazards Models
Tegafur
Chemotherapy
business.industry
Proportional hazards model
Cancer
ORIGINAL REPORTS
Middle Aged
medicine.disease
Prognosis
Gene Expression Regulation
Neoplastic
Treatment Outcome
Multicenter study
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Predictive value of tests
Colonic Neoplasms
Multivariate Analysis
030211 gastroenterology & hepatology
Female
Neoplasm Recurrence
Local
business
Zdroj: Journal of Clinical Oncology
ISSN: 1527-7755
0732-183X
Popis: PURPOSE The International Union Against Cancer highlighted tumor budding as a tumor-related prognostic factor. International assessment criteria for tumor budding were recently defined by the 2016 International Tumor Budding Consensus Conference (ITBCC2016). This study aimed to clarify the prognostic and predictive values of tumor budding in a randomized controlled trial evaluating the superiority of adjuvant chemotherapy with oral tegafur-uracil over surgery alone for stage II colon cancer (SACURA trial; ClinicalTrials.gov identifier: NCT00392899 ). PATIENTS AND METHODS Between 2006 and 2010, we enrolled 991 patients from 123 institutions with stage II colon cancer. Tumor budding was diagnosed by central review on the basis of the criteria adopted in the ITBCC2016. We prospectively recorded all clinical and pathologic data, including the budding grade, and performed prognostic analyses after 5 years of completing the patients’ registration. RESULTS Of 991 tumors, 376, 331, and 284 were classified as BD1, BD2, and BD3, respectively; the 5-year relapse-free survival (RFS) rate was 90.9%, 85.1%, and 74.4%, respectively ( P < .001), and ranged widely in T4 tumors (86.6% to 53.3%). The budding grade significantly correlated with recurrence in the liver, lungs, lymph nodes, and peritoneum ( P < .001 to .01). Multivariable analysis revealed that budding and T stage exerted an independent impact on RFS, and on the basis of the Harrell concordance index, these two factors substantially contributed to the improvement of the Cox model for predicting RFS. Both the BD2 and BD3 groups demonstrated greater improvement in the 5-year recurrence rate in the adjuvant chemotherapy group than the surgery-alone group by approximately 5%, but the difference was statistically nonsignificant. CONCLUSION Tumor budding grade on the basis of the ITBCC2016 criteria should be routinely evaluated in pathologic practice and could improve the benefit of adjuvant chemotherapy for stage II colon cancer.
Databáze: OpenAIRE
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