Journal of Cancer Research and Clinical Oncology

, Volume 145, Issue 2, pp 471–477 | Cite as

A novel histologic grading system based on lymphovascular invasion, perineural invasion, and tumor budding in colorectal cancer

  • Jung Wook Huh
  • Woo Yong LeeEmail author
  • Jung Kyong Shin
  • Yoon Ah Park
  • Yong Beom Cho
  • Hee Cheol Kim
  • Seong Hyeon Yun
Original Article – Clinical Oncology



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.


Prognosis 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).

Compliance with ethical standards

Conflict of interest

The authors declare no potential conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgerySamsung Medical Center, Sungkyunkwan University School of MedicineSeoulSouth Korea

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