Molecular subtypes of colorectal cancer – brief review

Sa？etak The failure of the AJCC/UICC staging system in predicting prognosis in intermediate-stage of colorectal cancers (CRCs) may be overcome by adding tumor budding (TB) in pathology report as the presence of high-grade TB has been consistently associated with negative clinicopathologic parameters in gastrointestinal tumors, especially in CRCs. Over the past few decades, numerous methods of assessing TB in CRC have been proposed, with variations in the area of assessment, cut-off values, and use of standard hematoxylin and eosin (H&E) stained slides vs. cytokeratin immunohistochemistry. This review summarizes previous studies in this scientific area and resulting guidelines. The concept of whether peritumoral budding (PTB) vs. intratumoral budding (ITB), or both, should be assesed is still under discussion. The original studies on TB utilized PTB, or assesment of budding at the invasive front of the CRC, and current guidelines pertain to that. Budding category and tumor grade are not the same and TB has an independent prognostic value and should be taken into account along with other clinicopathological factors in a multidisciplinary setting. TB should be routinely reported in stage II CRC, next to other high-risk factors, in order to aid the decision for adjuvant therapy