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10.1245/s10434-008-9901-6
Annals of Surgical Oncology 15:1977-1982 (2008)
© 2008 Society of Surgical Oncology
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Original Article

Multivariate Analysis of the Pathologic Features of Esophageal Squamous Cell Cancer: Tumor Budding Is a Significant Independent Prognostic Factor

Masahiko Koike, MD, PhD1, Yasuhiro Kodera, MD, PhD1, Yuichi Itoh, MD1, Goro Nakayama, MD, PhD1, Michitaka Fujiwara, MD, PhD1, Nobuyuki Hamajima, MD, PhD2 and Akimasa Nakao, MD, PhD1

1 Department of Surgery II, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
2 Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan

Correspondence: Address correspondence and reprint requests to: Masahiko Koike, MD, PhD; E-mail: dockoike{at}med.nagoya-u.ac.jp

Background: Tumor budding has been suggested to be a prognostic factor in various cancers but has never been studied in esophageal cancer.

Methods: In this study, the microscopic finding of tumor budding in esophageal squamous cell carcinoma was correlated with outcome after esophagectomy. One hundred and thirty-six patients undergoing a curative esophagectomy were assigned to either a frequent (n = 82) or rare (n = 54) group according to the microscopically observed frequency of tumor budding in the tumor.

Results: The 5-year survival rates after esophagectomy were 35.4% for the frequent group and 81.3% for the rare group. Multivariate analysis using the Cox proportional hazards model by a stepwise method identified this morphological variable as a significant independent prognostic factor.

Conclusions: Tumor budding in esophageal squamous cell carcinoma reflects the biological activity of the tumor and may be a useful prognostic indicator.

Key Words: Tumor budding • Prognosis • Esophageal cancer • Squamous cell cancer • Esophagectomy






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