A novel histologic grading system based on lymphovascular invasion, perineural invasion, and tumor budding in colorectal cancer
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This study aimed to evaluate the prognostic significance of lymphovascular (LVI), perineural invasion (PNI), and tumor budding positivity in patients with colorectal cancer.
From January 2008 to December 2011, 3707 consecutive patients who underwent curative surgery for stage I–III colorectal cancer were assessed. These patients were then categorized into four groups based on LVI, PNI, and tumor budding (risk grouping): all negative (n = 1495), 1 + only (n = 1063), 2 + only (n = 861), and all positive (n = 288).
With a median follow-up period of 52 months, the 5-year disease-free survival rates of the risk groups were significantly different in terms of cancer staging (stage I, Stage II, and Stage III: P = 0.006, P < 0.001, and P < 0.001, respectively). In the multivariate analysis, risk grouping was an independent prognostic factor of disease-free survival. Preoperative carcinoembryonic antigen level, tumor size, T category, and N category were independent predictors of LVI, PNI, and tumor budding positivity.
Risk grouping based on LVI, PNI, and tumor budding positivity is a strong predictor of disease-free survival in patients with colorectal cancer.
KeywordsPrognosis Lymphovascular invasion Perineural invasion Tumor budding Colorectal cancer
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (grant number 2015R1A1A1A05001160).
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Conflict of interest
The authors declare no potential conflicts of interest.