Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016

Lugli A, Kirsch R, Ajioka Y, Bosman F, Cathomas G, Dawson H, El Zimaity H, Flejou JF, Hansen TP, Hartmann A, Kakar S, Langner C, Nagtegaal I, Puppa G, Riddell R, Ristimaki A, Sheahan K, Smyrk T, Sugihara K, Terris B, Ueno H, Zlobec I, Quirke P, Vieth M (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Book Volume: 30

Pages Range: 1299-1311

Journal Issue: 9

DOI: 10.1038/modpathol.2017.46

Abstract

Tumor budding is a well-established independent prognostic factor in colorectal cancer but a standardized method for its assessment has been lacking. The primary aim of the International Tumor Budding Consensus Conference (ITBCC) was to reach agreement on an international, evidence-based standardized scoring system for tumor budding in colorectal cancer. The ITBCC included nine sessions with presentations, a pre-meeting survey and an e-book covering the key publications on tumor budding in colorectal cancer. The 'Grading of Recommendation Assessment, Development and Evaluation' method was used to determine the strength of recommendations and quality of evidence. The following 10 statements achieved consensus: tumor budding is defined as a single tumor cell or a cell cluster consisting of four tumor cells or less (22/22, 100%). Tumor budding is an independent predictor of lymph node metastases in pT1 colorectal cancer (23/23, 100%). Tumor budding is an independent predictor of survival in stage II colorectal cancer (23/23, 100%). Tumor budding should be taken into account along with other clinicopathological features in a multidisciplinary setting (23/23, 100%). Tumor budding is counted on H&E (19/22, 86%). Intratumoral budding exists in colorectal cancer and has been shown to be related to lymph node metastasis (22/22, 100%). Tumor budding is assessed in one hotspot (in a field measuring 0.785 mm2) at the invasive front (22/22, 100%). A three-tier system should be used along with the budding count in order to facilitate risk stratification in colorectal cancer (23/23, 100%). Tumor budding and tumor grade are not the same (23/23, 100%). Tumor budding should be included in guidelines/protocols for colorectal cancer reporting (23/23, 100%). Members of the ITBCC were able to reach strong consensus on a single international, evidence-based method for tumor budding assessment and reporting. It is proposed that this method be incorporated into colorectal cancer guidelines/protocols and staging systems.

Authors with CRIS profile

Involved external institutions

Universität Bern Switzerland (CH) University of Toronto Canada (CA) Niigata University / 新潟大学 Japan (JP) Université de Lausanne (UNIL) Switzerland (CH) Kantonsspital Baselland Switzerland (CH) Dynacare Laboratory and Health Services Centre Canada (CA) University of Paris 6 - Pierre et Marie Curie / Université Paris VI Pierre et Marie Curie (UPMC) France (FR) Copenhagen University Hospital Denmark (DK) University of California San Francisco (UCSF) United States (USA) (US) Medizinische Universität Graz Austria (AT) Radboud University Nijmegen Netherlands (NL) Geneva University Hospitals / Hôpitaux universitaires de Genève (HUG) Switzerland (CH) Helsingin yliopisto / University of Helsinki Finland (FI) St Vincent's University Hospital Ireland (IE) Mayo Clinic United States (USA) (US) Tokyo Medical and Dental University (TMDU) / 東京医科歯科大学 Japan (JP) Hôpital Cochin France (FR) National Defense Medical College / 防衛医科大学校 Japan (JP) University of Leeds United Kingdom (GB) Klinikum Bayreuth Germany (DE)

How to cite

APA:

Lugli, A., Kirsch, R., Ajioka, Y., Bosman, F., Cathomas, G., Dawson, H.,... Vieth, M. (2017). Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016. Modern Pathology, 30(9), 1299-1311. https://dx.doi.org/10.1038/modpathol.2017.46

MLA:

Lugli, Alessandro, et al. "Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016." Modern Pathology 30.9 (2017): 1299-1311.

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