Tumour Budding as Independent Predictor for Clinical Staging of Colorectal Cancer: A Single Center Study

Background: Colorectal cancer is a major global health issue, ranking third in incidence and second in mortality. Tumour budding has emerged as a significant independent prognostic factor, aiding in the prediction of recurrence and survival in colorectal cancer patients. This study aims to investigate its role in the clinical stage of colorectal cancer. Methods: This study was an observational analytic study with a cross-sectional design. The study sample was all colorectal cancer patients who underwent definitive surgery without neoadjuvant chemotherapy or radiotherapy at Prof. I.G.N.G Ngoerah Hospital, Denpasar, Indonesia. Results: Age in this study was found to have a mean of 59.56 ± 13.00. The most common gender is male, and the most common tumour location is the rectum, with as many as 17 (28.8%). The most histopathological grade was low grade, 48 (81.4%) subjects with the most histomorphology was moderately diff 33 (55.95). LVI result was negative 33 (55.9%), clinical stage III-IV 43 (72.9%), depth of invasion T3-T4 43 (72.9%), positive nodal status 40 (67.8%), and without metastasis 39 (66.1%). Budding tumours were found to be mostly low-grade with 23 (39%). High tumour budding was associated with the high clinical stage (III-IV) with RR 5.209 (95% CI 0.744-36.464; P=0.039), associated with depth of invasion T3-T4 with RR 5.209 (95% CI 0.744-36.464; P=0.039) and weakly correlated (r=0.283; p=0.030), also associated with positive nodal status with RR 6.650 (95% CI 0.942-46.922; P=0.014) and weakly correlated (r=0.386; p-0.003). Conclusions: High tumour budding is associated with a high clinical stage, high depth of invasion, and positive nodal status.