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High tumor budding predicts a poor prognosis in resected duodenal adenocarcinoma

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Abstract

Purpose

Tumor budding is a histological characteristic defined as the presence of small clusters of cancer cells at the invasion front. Its significance in duodenal adenocarcinoma (DA) has not been fully described.

Methods

A single-center, retrospective study was conducted. Patients who underwent curative surgery for histologically diagnosed DA from January 2006 to December 2018 at Kansai Medical University Hospital were included. Tumor budding was counted per 0.785 mm2 and classified as low (0–4 buds), intermediate (5–9 buds), or high (≥ 10 buds).

Results

In total, 47 patients were included. The 5-year overall survival and relapse-free survival rates were 77% and 72%, respectively. High tumor budding was seen in 15 patients (32%). Excluding patients with superficial type (pT1) DA (n = 22), high tumor budding [hazard ratio (HR) 13.4, p = 0.028], regional lymph node metastasis (HR 19.9, p = 0.039), and adjuvant chemotherapy (HR 0.056, p = 0.036) were independent factors related to the overall survival in multivariate analyses. Distant metastases occurred significantly more often in patients who had high tumor budding than in others (p = 0.039).

Conclusion

The data suggest that high tumor budding is a predictor of a poor prognosis in resected DA.

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Abbreviations

BMI:

Body mass index

CA:

Carbohydrate antigen

CEA:

Carcinoembryonic antigen

CECT:

Contrast-enhanced computed tomography

DA:

Duodenal adenocarcinoma

HR:

Hazard ratio

MRI:

Magnetic resonance imaging

OS:

Overall survival

PET:

Positron emission tomography

RFS:

Relapse-free survival

LN:

Lymph node

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Authors and Affiliations

  1. Department of Surgery, Kansai Medical University, 2-5-1 Shin-machi, Hirakata-city, Osaka, 573-1010, Japan

    Tatsuma Sakaguchi, Sohei Satoi, Daisuke Hashimoto, Tomohisa Yamamoto, So Yamaki, Satoshi Hirooka, Kentaro Inoue & Mitsugu Sekimoto

  2. Department of Pathology and Clinical Laboratory, Kansai Medical University, Osaka, Japan

    Mitsuaki Ishida

  3. The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan

    Tsukasa Ikeura & Makoto Naganuma

  4. Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Hideki Ishikawa

Authors
  1. Tatsuma Sakaguchi
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  2. Sohei Satoi
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Contributions

TS conducted the data acquisition, statistical analysis, and drafting a major part of the manuscript. SS is a corresponding author who conceived and designed the study and revised the manuscript. DH, TY, SY, SH, KI, TI, MN, and MS cooperated in the acquisition of clinical data and revised the manuscript critically for important intellectual content. MI evaluated all histopathological diagnoses and revised the manuscript. HI is responsible for the statistical analyses of this study and revised the manuscript. All authors approved the manuscript to be published.

Corresponding author

Correspondence to Sohei Satoi.

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Sakaguchi, T., Satoi, S., Hashimoto, D. et al. High tumor budding predicts a poor prognosis in resected duodenal adenocarcinoma. Surg Today 52, 931–940 (2022). https://doi.org/10.1007/s00595-021-02433-z

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  • DOI: https://doi.org/10.1007/s00595-021-02433-z

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