Tumor budding in colorectal cancer—Information for clinical use and instructions for practical evaluation

Abstract

Background: Some patients with high-risk colorectal cancer show a worse prognosis within the same UICC stage. Therefore, the identification of additional risk factors is necessary to find the best treatment for these patients. Objective: In which settings can tumor budding help the clinical decision-making process for treatment planning and how should scoring be performed? Material and methods: Evaluation of current publications on tumor budding with an emphasis on practical grading and potential problems in the determination of tumor budding. Results: Tumor budding is a significant risk factor for worse clinical outcome of colorectal cancer and can influence clinical decision-making in pT1 and stage II colorectal cancer. A scoring method was standardized by the ITBCC 2016 and is feasible in everyday practice. Challenges in assessment can be addressed by increasing awareness of potential problem cases.