Tumor budding and evidence-based treatment of T2 rectal carcinomas
Article first published online: 22 SEP 2005
Copyright © 2005 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 92, Issue 1, pages 59–63, 1 October 2005
How to Cite
Masaki, T., Matsuoka, H., Sugiyama, M., Abe, N., Sakamoto, A., Watanabe, T., Nagawa, H. and Atomi, Y. (2005), Tumor budding and evidence-based treatment of T2 rectal carcinomas. J. Surg. Oncol., 92: 59–63. doi: 10.1002/jso.20369
- Issue published online: 22 SEP 2005
- Article first published online: 22 SEP 2005
- Manuscript Accepted: 27 JUL 2005
- Manuscript Received: 27 DEC 2004
- KAKENHI. Grant Number: 15591440
- T2 rectal carcinoma;
- lymph node metastasis;
- local excision;
- tumor budding;
- decision analysis
The validity of the histological criteria in deciding additional bowel resection after local excision of T2 rectal carcinomas is questioned.
In 72 T2 colorectal carcinomas resected by major surgery, the associations between lymph node metastasis (LNM) and clinicopathologic parameters were examined statistically, a prediction formula for LNM was constructed and decision analysis was attempted.
Multivariate analysis showed that female gender and a greater number of tumor budding were significantly associated with LNM. The probability of LNM can be calculated as follows; Z = 0.037 × (budding number) + 2.08 × (SEX; male, 1; female, 2) − 5.736; Probability = 1/1 + e−Z. When a 75-year-old patient has pulmonary complications, the operative risk is assumed to be over 2%. If a number of tumor budding is 0, the risk of LNM is calculated as 2.4% in a male and 17.1% in a female patient. On the assumption that the risk of liver metastasis is half of that of LNM, and the salvageabilities after LNM and liver metastasis are 20% and 50%, respectively, observation policy is justified for a male patient, whereas additional surgery should be undertaken for a female patient.
A number of tumor budding may be useful for determining the individualized treatment of T2 rectal carcinomas. J. Surg. Oncol. 2005;92:59–63. © 2005 Wiley-Liss, Inc.