Prognostic role of high-grade tumor budding in pancreatic ductal adenocarcinoma

A systematic review and meta-analysis with a focus on epithelial to mesenchymal transition

Rita T. Lawlor, Nicola Veronese, Alessia Nottegar, Giuseppe Malleo, Lee Smith, Jacopo Demurtas, Liang Cheng, Laura Delong Wood, Nicola Silvestris, Roberto Salvia, Aldo Scarpa, Claudio Luchini

Research output: Contribution to journalReview article

Abstract

This study aims at clarifying the prognostic role of high-grade tumor budding (TB) in pancreatic ductal adenocarcinoma (PDAC) with the first systematic review and meta-analysis on this topic. Furthermore, we analyzed with a systematic review the relationship between TB and a recently suggested TB-associated mechanism: the epithelial to mesenchymal transition (EMT). Analyzing a total of 613 patients, 251 of them (40.9%) with high grade-TB, we found an increased risk of all-cause mortality (RR, 1.46; 95% CI, 1.13-1.88, p = 0.004; HR, 2.65; 95% CI, 1.79-3.91; p < 0.0001) and of recurrence (RR, 1.61; 95% CI, 1.05-2.47, p = 0.03) for PDAC patients with high-grade TB. Moreover, we found that EMT is a central process in determining the presence of TB in PDAC. Thanks to this meta-analysis, we demonstrate the potential clinical significance of high-grade TB for prognostic stratification of PDAC. TB also shows a clear association with the process of EMT. Based on the results of the present study, TB should be conveyed in pathology reports and taken into account by future oncologic staging systems.

Original languageEnglish (US)
Article number113
JournalCancers
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Epithelial-Mesenchymal Transition
Meta-Analysis
Adenocarcinoma
Neoplasms
Pathology
Recurrence
Mortality

Keywords

  • Budding
  • Buds
  • EMT
  • Epithelial to mesenchymal transition
  • Pancreatic cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Prognostic role of high-grade tumor budding in pancreatic ductal adenocarcinoma : A systematic review and meta-analysis with a focus on epithelial to mesenchymal transition. / Lawlor, Rita T.; Veronese, Nicola; Nottegar, Alessia; Malleo, Giuseppe; Smith, Lee; Demurtas, Jacopo; Cheng, Liang; Wood, Laura Delong; Silvestris, Nicola; Salvia, Roberto; Scarpa, Aldo; Luchini, Claudio.

In: Cancers, Vol. 11, No. 1, 113, 01.01.2019.

Research output: Contribution to journalReview article

Lawlor, RT, Veronese, N, Nottegar, A, Malleo, G, Smith, L, Demurtas, J, Cheng, L, Wood, LD, Silvestris, N, Salvia, R, Scarpa, A & Luchini, C 2019, 'Prognostic role of high-grade tumor budding in pancreatic ductal adenocarcinoma: A systematic review and meta-analysis with a focus on epithelial to mesenchymal transition', Cancers, vol. 11, no. 1, 113. https://doi.org/10.3390/cancers11010113
Lawlor, Rita T. ; Veronese, Nicola ; Nottegar, Alessia ; Malleo, Giuseppe ; Smith, Lee ; Demurtas, Jacopo ; Cheng, Liang ; Wood, Laura Delong ; Silvestris, Nicola ; Salvia, Roberto ; Scarpa, Aldo ; Luchini, Claudio. / Prognostic role of high-grade tumor budding in pancreatic ductal adenocarcinoma : A systematic review and meta-analysis with a focus on epithelial to mesenchymal transition. In: Cancers. 2019 ; Vol. 11, No. 1.
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abstract = "This study aims at clarifying the prognostic role of high-grade tumor budding (TB) in pancreatic ductal adenocarcinoma (PDAC) with the first systematic review and meta-analysis on this topic. Furthermore, we analyzed with a systematic review the relationship between TB and a recently suggested TB-associated mechanism: the epithelial to mesenchymal transition (EMT). Analyzing a total of 613 patients, 251 of them (40.9{\%}) with high grade-TB, we found an increased risk of all-cause mortality (RR, 1.46; 95{\%} CI, 1.13-1.88, p = 0.004; HR, 2.65; 95{\%} CI, 1.79-3.91; p < 0.0001) and of recurrence (RR, 1.61; 95{\%} CI, 1.05-2.47, p = 0.03) for PDAC patients with high-grade TB. Moreover, we found that EMT is a central process in determining the presence of TB in PDAC. Thanks to this meta-analysis, we demonstrate the potential clinical significance of high-grade TB for prognostic stratification of PDAC. TB also shows a clear association with the process of EMT. Based on the results of the present study, TB should be conveyed in pathology reports and taken into account by future oncologic staging systems.",
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AU - Smith, Lee

AU - Demurtas, Jacopo

AU - Cheng, Liang

AU - Wood, Laura Delong

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AB - This study aims at clarifying the prognostic role of high-grade tumor budding (TB) in pancreatic ductal adenocarcinoma (PDAC) with the first systematic review and meta-analysis on this topic. Furthermore, we analyzed with a systematic review the relationship between TB and a recently suggested TB-associated mechanism: the epithelial to mesenchymal transition (EMT). Analyzing a total of 613 patients, 251 of them (40.9%) with high grade-TB, we found an increased risk of all-cause mortality (RR, 1.46; 95% CI, 1.13-1.88, p = 0.004; HR, 2.65; 95% CI, 1.79-3.91; p < 0.0001) and of recurrence (RR, 1.61; 95% CI, 1.05-2.47, p = 0.03) for PDAC patients with high-grade TB. Moreover, we found that EMT is a central process in determining the presence of TB in PDAC. Thanks to this meta-analysis, we demonstrate the potential clinical significance of high-grade TB for prognostic stratification of PDAC. TB also shows a clear association with the process of EMT. Based on the results of the present study, TB should be conveyed in pathology reports and taken into account by future oncologic staging systems.

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