A Study on Prognostic Value of Tumor Budding in Patients with Rectal Cancer

Two hundred ninety-seven patients who underwent rectal adenocarcinoma resection from 1978 to 1988 were studied retrospectively to evaluate the prognostic value of tumor budding. The surgical specimens were examined for histological evidence of budding, defined as small clusters of poorly differentiated or undifferentiated cancer cells ahead of the invasive front of the lesion. Patients were divided into two groups according to the degree of budding: none or mild (bd0, 1) and moderate or severe (bd2, 3). Of the 297 patients, bd0, 1 was seen in 181 patients (61%) and bd2, 3 in 116 (39%). Higher grade budding was associated with a significantly higher recurrence rate; 51% for bd2, 3 patients vs 19% for bd0, 1 for bd0, 1 patients. The five-year cumulative survival rate was worse in bd2, 3 than bd0, 1 (46% vs 79%, p