The Role of Tumour Budding at the Front of Invasion and Recurrence of Rectal Carcinoma

Abstract

The presence of “tumour budding”, i.e. single cancer cells, or a nest of poorly- differentiated cells at the front of invasion, in bowel cancer appears to be a new histopathological indicator of increased aggressiveness of colorectal carcinoma.The aim of this work was a retrospective evaluation of the front of invasion in preoperative biopsies of patients with rectal carcinoma (T1) and an analysis of the relationship between tumour budding and metastases or recurrence of the tumour at the site of resection. Patients and Methods: The study was performed based on material obtained before and during surgical treatment of 34 patients with cancer of the colon. Tissue was obtained directly following tumour resection, fixed in 10% formaldehyde and embedded in paraffin blocks using a routine method by melting with paraffin at a temperature of 56°C. These samples were then routinely stained with haemotoxylin and eosin and underwent a histopathological evaluation, with particular attention being paid to the front of invasion of the tumour. Results: Tumour budding (TB) at the front of invasion was found in 12 out of 34 patients. Statistical analysis showed a correlation between TB and the histological type of tumour, the presence of lymph node metastases, distant metastases and recurrence of the tumour in post-operative scars. Conclusion:The results suggest the usefulness of evaluating TB at the front of invasion as an additional prognostic indicator in rectal carcinoma.