Histologic features for identification of high-risk stage II colorectal cancer

Aim: This study aims to identify stage II colorectal cancers with high recurrence risk based on histologic assessment.
Methods: Patients with stage II colorectal cancers undergoing surgical resection in our hospital from January to December 2004 (n = 56) were recruited and their corresponding follow-up data were retrieved. Histological parameters including tumor grade, lymphovascular invasion (LVI), poorly-differentiated clusters (PDCs), tumor budding (TB), and T-staging were reviewed.
Results: TB and PDCs were found to be positively correlated (Spearman's rho 0.672, P < 0.001). A combined TB and PDC score was constructed: both TB and PDC less than 5, either TB or PDC greater than or equal to 5, and both TB and PDC greater than or equal to 5. Multivariable Cox regression analysis showed that pT4 disease (hazard ratio (HR) 5.72, 95% confidence interval (CI) 1.27-25.76, P = 0.023), LVI (HR 6.24, 95% CI: 1.11-35.27, P = 0.038) and TB/PDC score (HR 4.81, 95% CI: 1.78-13.01, P = 0.002) were independent prognostic factors predicting tumor recurrence.
Conclusion: Pathological parameters (pT4, LVI, PDCs and TB) were associated with recurrence, which may aid in prognostication and identify patients potentially benefiting from adjuvant therapy.