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JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Special Issue "Pathology", March, 2023

Pages: 1150-1150
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Prognostic impact of tumor budding on moroccan gastric cancer patients.

Author: Souhaila El Yaagoubi, Meryem Zaryouhi, Soumaya Benmaamar, Fatima El Agy, Layla Tahiri El Ousrouti, Nawal Hammas, Hicham El Bouhaddouti, Zineb Benbrahim, Nada Lahmidani, Laila Chbani

Category: JMSR Pathology

Abstract:

Background: Tumour budding (TB) has been defined as an independent prognostic factor in many carcinomas like colon adenocarcinoma, but its prognostic impact on gastric cancer patients remains not well established. In the present study, we aimed to highlight the correlation of tumor budding with clinico-pathological features and predict its survival outcomes in gastric cancer patients for the first time in the Moroccan population.

Methods. This study was conducted on 83 patients who underwent surgery for gastric adenocarcinoma from 2014 to 2020. The patient’s clinico-pathological characteristics were obtained from the pathological and clinical records of each patient. Tumor budding was assessed on HES slides, according to the 2016 International Tumor Budding Consensus Conference criteria. The association of tumor budding grades with categorical and continuous variables were respectively assessed by the χ2-test and the unpaired t-test. Survival analysis was performed by the Kaplan-Meier method, the log-rank test.

Results. Patients consisted of 65.1% of men and 34.9% of women with a median age of 61,3 years. Histologically, the majority of the tumors were adenocarcinoma (65,1%). Among all cases, 3.6% (3/83) were classified as Bud 0, 14.5% as Bud1 (12/83), (27/83) 32.5%% as Bud 2, and 49.4% (41/83) as Bud 3 grades. High-grade tumor budding (BUD 3) was found to be significantly associated with special clinicopathological features including older age (P=0.02), Unradical resection (R1/R2) (P=0.03), and the presence of vascular invasion (P=0.05), and perineural invasion (P=0.04). Furthermore, tumors with high-grade tumor budding were significantly associated with a low rate of resected lymph nodes (P=0.04) and advanced TNM stage (P=0.02). Among all stages, high-grade tumor budding was correlated with shorter overall survival in univariate and multivariate analysis (P=0.04). Patients with high- tumor budding had worse relapse-free survival compared with patients with low- tumor budding grade and those without tumor budding (P=0.01).

Conclusion. According to our study, the high-tumor budding grade was correlated with unfavorable clinicopathological features and poorer survival. The present study findings suggest that Tumor Budding should be considered in the treatment and prognosis of gastric cancer patients.

Keywords: Gastric cancer. Tumor budding. Survival.

Full Text:

Prognostic impact of tumor budding on moroccan gastric cancer patients

Souhaila El Yaagoubi ac, Meryem Zaryouhi ac, Soumaya Benmaamard, Fatima El Agya, Layla Tahiri El Ousrouti ac, Nawal Hammas abc, Hicham El Bouhaddouti e, Zineb Benbrahimf , Nada Lahmidani g, Laila Chbani abc.

a : Departement of Pathology, Hassan II University Hospital, b: Biomedical and Translational Research Laboratory, c : Faculty of Medicine, Pharmacy, and Dental Medicine of Fez, University Sidi Mohamed Ben Abdellah, d: Departement of Epidemiology, e: Departement of General Surgery, f: Department of Oncology, g: Department of Gastrology, Hassan II University Hospital, Fez, Morocco.

Corresponding author:

Souhaila Elyaagoubi,

Departement of Pathology, Hassan II University Hospital, Fez, Morocco.

Background: Tumour budding (TB) has been defined as an independent prognostic factor in many carcinomas like colon adenocarcinoma, but its prognostic impact on gastric cancer patients remains not well established. In the present study, we aimed to highlight the correlation of tumor budding with clinico-pathological features and predict its survival outcomes in gastric cancer patients for the first time in the Moroccan population.

Methods. This study was conducted on 83 patients who underwent surgery for gastric adenocarcinoma from 2014 to 2020. The patient’s clinico-pathological characteristics were obtained from the pathological and clinical records of each patient. Tumor budding was assessed on HES slides, according to the 2016 International Tumor Budding Consensus Conference criteria. The association of tumor budding grades with categorical and continuous variables were respectively assessed by the χ2-test and the unpaired t-test. Survival analysis was performed by the Kaplan-Meier method, the log-rank test.

Results. Patients consisted of 65.1% of men and 34.9% of women with a median age of 61,3 years. Histologically, the majority of the tumors were adenocarcinoma (65,1%). Among all cases, 3.6% (3/83) were classified as Bud 0, 14.5% as Bud1 (12/83), (27/83) 32.5%% as Bud 2, and 49.4% (41/83) as Bud 3 grades. High-grade tumor budding (BUD 3) was found to be significantly associated with special clinicopathological features including older age (P=0.02), Unradical resection (R1/R2) (P=0.03), and the presence of vascular invasion (P=0.05), and perineural invasion (P=0.04). Furthermore, tumors with high-grade tumor budding were significantly associated with a low rate of resected lymph nodes (P=0.04) and advanced TNM stage (P=0.02). Among all stages, high-grade tumor budding was correlated with shorter overall survival in univariate and multivariate analysis (P=0.04). Patients with high- tumor budding had worse relapse-free survival compared with patients with low- tumor budding grade and those without tumor budding (P=0.01).

Conclusion. According to our study, the high-tumor budding grade was correlated with unfavorable clinicopathological features and poorer survival. The present study findings suggest that Tumor Budding should be considered in the treatment and prognosis of gastric cancer patients.

Keywords: Gastric cancer. Tumor budding. Survival.

References:

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