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Title:           Analysis of tumor budding as a prognostic factor for recurrence in patients with stage II and III colon cancer. Experience in a tertiary hospital
Subject:         DOI: 10.1093/oncolo/oyaf027
The Oncologist, Volume. 30, Issue. 3, 27 March 2025
Abstract 
Background:  Stage II and III colorectal cancer (CRC) poses a significant challenge due to rising global incidence and mortality rates. Despite advancements in screening and treatment, there's a pressing need for reliable prognostic biomarkers. Tumor budding emerges as a promising marker associated with poor prognosis and higher recurrence. However, its incorporation into clinical guidelines differs when considering adjuvant treatment. This study assesses tumor budding's prognostic value for recurrence in stage II and III CRC, exploring its implications for risk stratification.
Methods:  This retrospective study encompassed patients with stage II-III CRC at Hospital Universitario La Paz from October 2016 to January 2022. Tumor budding was assessed according to the 2016 ITBCC guidelines and categorized as low, intermediate, or high. The primary outcomes, time to recurrence (TTR) and overall survival (OS), were analyzed using Kaplan-Meier and Cox regression models.
Results:  A total of 390 patients were included in the final analysis. They were predominantly male (55%) with an average age of 75 years (range 35-95). Fifty percent of patients were stage II. Tumor budding was categorized as low, intermediate, and high in 186 (48%), 110 (28%), and 94 (24%) patients, respectively. After a median follow-up of 46.1 months, there were 71 recurrences and 96 deaths. Time to recurrence (TTR) was significantly shorter for patients with high tumor budding. At 24 months, freedom from recurrence was 92%, 84%, and 69% for low, intermediate, and high tumor budding groups, respectively. Median TTR was not reached in any group. Multivariate analysis revealed high-grade budding as an independent predictor of recurrence with a hazard ratio (HR) of 2.39 (P = .01; 95% CI, [1.42-4.04]).
Conclusion:  Our study highlights the prognostic value of tumor budding in predicting recurrence in both stage II and III colorectal cancer patients, reinforcing its potential as an important biomarker beyond stage II CRC.
Author:          Antonio Rueda-Lara,David Viñal,Daniel Martínez-Pérez,María Alameda-Guijarro,Gema Martin-Montalvo,Sergio Martínez-Recio,Jesús Peña-Lopez,Diego Jiménez-Bou,Icíar Ruíz-Gutiérrez,Andrea García-Leal,Patricia Zwisler-Contreras,Ismael Ghanem,Ana Belén Custodio,Pablo Pérez-Wert,Laura Gutiérrez-Sainz,Maria Elena Palacios,Jaime Feliu,Nuria Rodríguez-Salas
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     Item: 
      Title: Analysis of tumor budding as a prognostic factor for recurrence in patients with stage II and III colon cancer. Experience in a tertiary hospital
      Children: 
       Item: 
        Title: Introduction
       Item: 
        Title: Methodology
       Item: 
        Title: Results
        Children: 
         Item: 
          Title: Population characteristics
         Item: 
          Title: Recurrence and survival analysis
         Item: 
          Title: Survival according to TNM stage at diagnosis
       Item: 
        Title: Discussion
       Item: 
        Title: Conclusion
       Item: 
        Title: Acknowledgments
       Item: 
        Title: References
   Info: 
    Author: Antonio Rueda-Lara,David Viñal,Daniel Martínez-Pérez,María Alameda-Guijarro,Gema Martin-Montalvo,Sergio Martínez-Recio,Jesús Peña-Lopez,Diego Jiménez-Bou,Icíar Ruíz-Gutiérrez,Andrea García-Leal,Patricia Zwisler-Contreras,Ismael Ghanem,Ana Belén Custodio,倀愀戀氀漠⼀倀爀攀稀ⴀ圀攀爀琀Ⰰ䰀愀甀爀愠⼀䜀甀琀椀爀爀攀稀ⴀ匀愀椀渀稀Ⰰ䴀愀爀椀愀 䔀氀攀渀愠⼀倀愀氀愀挀椀漀猀Ⰰ䨀愀椀洀攠⼀䘀攀氀椀甀Ⰰ一甀爀椀愠⼀刀漀搀爀最甀攀稀ⴀ匀愀氀愀猩⽃牥慴楯湄慴攨䐺㈰㈵〳㈷ㄹ㐱ㄶ⬰㔧㌰✩⽃牥慴潲⡁摯扥⁉湄敳楧渠ㄵ⸱
坩湤潷猩
    Subject: DOI: 10.1093/oncolo/oyaf027
The Oncologist, Volume. 30, Issue. 3, 27 March 2025
Abstract 
Background:  Stage II and III color攀挀琀愀氀 挀愀渀挀攀爀 䌀刀䌀 瀀漀猀攀猀 愀 猀椀最渀椀昀椀挀愀渀琀 挀栀愀氀氀攀渀最攀 搀甀攀 琀漀 爀椀猀椀渀最 最氀漀戀愀氀 椀渀挀椀搀攀渀挀攀 愀渀搀 洀漀爀琀愀氀椀琀礀 爀愀琀攀猀⸀ 䐀攀猀瀀椀琀攀 愀搀瘀愀渀挀攀洀攀渀琀猀 椀渀 猀reening and treatment, there's a pressing need for reliable prognostic biomarkers. Tumor budding emerges as a promising marker 愀猀猀漀挀椀愀琀攀搀 眀椀琀栀 瀀漀漀爀 瀀爀漀最渀漀猀椀猀 愀渀搀 栀椀最栀攀爀 爀攀挀甀爀爀攀渀挀攀⸀ 䠀漀眀攀瘀攀爀Ⰰ 椀琀猀 椀渀挀漀爀瀀漀爀愀琀椀漀渀 椀渀琀漀 挀氀椀渀椀挀愀氀 最甀椀搀攀氀椀渀攀猀 搀椀昀昀攀爀猀 眀栀攀渀 挀漀渀猀椀搀攀爀ng adjuvant treatment. This study assesses tumor budding's prognostic value for recurrence in stage II and III CRC, exploring i琀猀 椀洀瀀氀椀挀愀琀椀漀渀猀 昀漀爀 爀椀猀欀 猀琀爀愀琀椀昀椀挀愀琀椀漀渀⸀䴀攀琀栀漀搀猀㨀  吀栀椀猀 爀攀琀爀漀猀瀀攀挀琀椀瘀攀 猀琀甀搀礀 攀渀挀漀洀瀀愀猀猀攀搀 瀀愀琀椀攀渀琀猀 眀椀琀栀 猀琀愀最攀 䤀䤀ⴀ䤀䤀䤀 䌀刀䌀 愀琀 䠀漀猀瀀椀琀愀氀 唀渀椀瘀攀爀猀椀琀愀爀椀漀 䰀愀 倀愀稀 昀爀漀洀 伀挀琀漀戀攀爀 ㈀　㄀㘀 琀漀 䨀愀渀甀愀爀礀 ㈀　㈀㈀⸀ 吀甀洀漀爀 戀甀搀搀椀渀最 眀愀猀 愀猀猀攀猀猀攀搀 愀挀挀漀爀搀椀渀最 琀漀 琀栀攀 ㈀　㄀㘀 䤀吀䈀䌀䌀 最甀椀搀攀氀椀渀攀猀 愀d categorized as low, intermediate, or high. The primary outcomes, time to recurrence (TTR) and overall survival (OS), were a渀愀氀礀稀攀搀 甀猀椀渀最 䬀愀瀀氀愀渀ⴀ䴀攀椀攀爀 愀渀搀 䌀漀砀 爀攀最爀攀猀猀椀漀渀 洀漀搀攀氀猀⸀刀攀猀甀氀琀猀㨀  䄀 琀漀琀愀氀 漀昀 ㌀㤀　 瀀愀琀椀攀渀琀猀 眀攀爀攀 椀渀挀氀甀搀攀搀 椀渀 琀栀攀 昀椀渀愀氀 愀渀愀氀礀猀椀猀⸀ 吀栀攀礀 眀攀爀攀 瀀爀攀搀漀洀椀渀愀渀琀氀礀 洀愀氀攀 㔀㔀─ 眀椀琀栀 愀渀 愀瘀攀爀愀最攀 愀最攀 漀昀 㜀㔀 礀攀愀爀猀 爀愀渀最攀 ㌀㔀ⴀ㤀㔀⸀ 䘀椀昀琀礀 瀀攀爀挀攀渀琀 漀昀 瀀愀琀椀攀渀琀猀 眀攀爀攀 猀琀愀最攀 䤀䤀⸀ 吀甀洀漀 budding was categorized as low, intermediate, and high in 186 (48%), 110 (28%), and 94 (24%) patients, respectively. After 愀 洀攀搀椀愀渀 昀漀氀氀漀眀ⴀ甀瀀 漀昀 㐀㘀⸀㄀ 洀漀渀琀栀猀Ⰰ 琀栀攀爀攀 眀攀爀攀 㜀㄀ 爀攀挀甀爀爀攀渀挀攀猀 愀渀搀 㤀㘀 搀攀愀琀栀猀⸀ 吀椀洀攀 琀漀 爀攀挀甀爀爀攀渀挀攀 吀吀刀 眀愀猀 猀椀最渀椀昀椀挀愀渀琀氀礀 猀栀漀爀琀攀爀for patients with high tumor budding. At 24 months, freedom from recurrence was 92%, 84%, and 69% for low, intermediate, and hi最栀 琀甀洀漀爀 戀甀搀搀椀渀最 最爀漀甀瀀猀Ⰰ 爀攀猀瀀攀挀琀椀瘀攀氀礀⸀ 䴀攀搀椀愀渀 吀吀刀 眀愀猀 渀漀琀 爀攀愀挀栀攀搀 椀渀 愀渀礀 最爀漀甀瀀⸀ 䴀甀氀琀椀瘀愀爀椀愀琀攀 愀渀愀氀礀猀椀猀 爀攀瘀攀愀氀攀搀 栀椀最栀ⴀ最爀愀搀攀 戀甀搀搀椀g as an independent predictor of recurrence with a hazard ratio (HR) of 2.39 (P = .01; 95% CI, [1.42-4.04]).
Conclusion:  Our study highlights the prognostic value of tumor budding in predicting recurrence in both stage II and III colorectal cancer pat椀攀渀琀猀Ⰰ 爀攀椀渀昀漀爀挀椀渀最 椀琀猀 瀀漀琀攀渀琀椀愀氀 愀猀 愀渀 椀洀瀀漀爀琀愀渀琀 戀椀漀洀愀爀欀攀爀 戀攀礀漀渀搀 猀琀愀最攀 䤀䤀 䌀刀䌀⸩⽔楴汥⡁湡汹獩猠潦⁴畭潲⁢畤摩湧⁡猠愠灲潧湯獴楣⁦慣瑯爠景爠牥捵牲敮捥⁩渠灡瑩敮瑳⁷楴栠獴慧攠䥉⁡湤⁉䥉⁣潬潮⁣慮捥爮⁅硰敲楥湣攠楮⁡⁴敲瑩慲礠桯獰楴慬
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               <rdf:li xml:lang="x-default">DOI: 10.1093/oncolo/oyaf027&#xD;The Oncologist, Volume. 30, Issue. 3, 27 March 2025&#xD;Abstract &#xD;Background:  Stage II and III colorectal cancer (CRC) poses a significant challenge due to rising global incidence and mortality rates. Despite advancements in screening and treatment, there's a pressing need for reliable prognostic biomarkers. Tumor budding emerges as a promising marker associated with poor prognosis and higher recurrence. However, its incorporation into clinical guidelines differs when considering adjuvant treatment. This study assesses tumor budding's prognostic value for recurrence in stage II and III CRC, exploring its implications for risk stratification.&#xD;Methods:  This retrospective study encompassed patients with stage II-III CRC at Hospital Universitario La Paz from October 2016 to January 2022. Tumor budding was assessed according to the 2016 ITBCC guidelines and categorized as low, intermediate, or high. The primary outcomes, time to recurrence (TTR) and overall survival (OS), were analyzed using Kaplan-Meier and Cox regression models.&#xD;Results:  A total of 390 patients were included in the final analysis. They were predominantly male (55%) with an average age of 75 years (range 35-95). Fifty percent of patients were stage II. Tumor budding was categorized as low, intermediate, and high in 186 (48%), 110 (28%), and 94 (24%) patients, respectively. After a median follow-up of 46.1 months, there were 71 recurrences and 96 deaths. Time to recurrence (TTR) was significantly shorter for patients with high tumor budding. At 24 months, freedom from recurrence was 92%, 84%, and 69% for low, intermediate, and high tumor budding groups, respectively. Median TTR was not reached in any group. Multivariate analysis revealed high-grade budding as an independent predictor of recurrence with a hazard ratio (HR) of 2.39 (P = .01; 95% CI, [1.42-4.04]).&#xD;Conclusion:  Our study highlights the prognostic value of tumor budding in predicting recurrence in both stage II and III colorectal cancer patients, reinforcing its potential as an important biomarker beyond stage II CRC.</rdf:li>
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               <rdf:li xml:lang="x-default">© The Author(s) 2025. Published by Oxford University Press.</rdf:li>
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               <rdf:li>Antonio Rueda-Lara,David Viñal,Daniel Martínez-Pérez,María Alameda-Guijarro,Gema Martin-Montalvo,Sergio Martínez-Recio,Jesús Peña-Lopez,Diego Jiménez-Bou,Icíar Ruíz-Gutiérrez,Andrea García-Leal,Patricia Zwisler-Contreras,Ismael Ghanem,Ana Belén Custodio,Pablo Pérez-Wert,Laura Gutiérrez-Sainz,Maria Elena Palacios,Jaime Feliu,Nuria Rodríguez-Salas</rdf:li>
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   Type: CRC32
  Checksum: d53027fc14927057c0ad3c0f2414640e
   Type: MD5
  Checksum: aa9f4698a8a2a90efb0f7c0f77155ba054a8219c
   Type: SHA-1
  Checksum: 5c7c19dc296c0a0d628128a2806c9b44e8eb2a50748a9b477285668d8b086e7c
   Type: SHA-256