Guo YX, Zhang ZZ, Zhao G, Zhao EH. Prognostic and pathological impact of tumor budding in gastric cancer: A systematic review and meta-analysis. World J Gastrointest Oncol 2019; 11(10): 898-908 [PMID: 31662828 DOI: 10.4251/wjgo.v11.i10.898]
Corresponding Author of This Article
En-Hao Zhao, PhD, Associate Professor, Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai 200120, China. microzhaoenhao@hotmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Oct 15, 2019; 11(10): 898-908 Published online Oct 15, 2019. doi: 10.4251/wjgo.v11.i10.898
Prognostic and pathological impact of tumor budding in gastric cancer: A systematic review and meta-analysis
Yi-Xian Guo, Zi-Zhen Zhang, Gang Zhao, En-Hao Zhao
Yi-Xian Guo, Zi-Zhen Zhang, Gang Zhao, En-Hao Zhao, Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200120, China
Author contributions: Guo YX and Zhang ZZ designed the study and wrote the manuscript; Guo YX and Zhang ZZ conducted the literature search; Guo YX and Zhang ZZ collected and retrieved the data; Guo YX and Zhang ZZ analyzed the data; Zhao EH and Zhao G critically reviewed and revised the manuscript; Guo YX, Zhang ZZ and Zhao EH contributed equally to this work; and all authors proofed the manuscript.
Supported byShanghai Shenkang Hospital Development Center Three-Year Action Plan for Difficult Diseases Precision Treatment Project, No. 16CR2022A; Pudong New Area Joint Research Project, No. PW2017D-1; Shanghai Shenkang Hospital Development Center Technology Joint Promotion Project, No. SHDC12016236; Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Training fund, No. PYMDT-003.
Conflict-of-interest statement: The authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: En-Hao Zhao, PhD, Associate Professor, Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai 200120, China. microzhaoenhao@hotmail.com
Telephone: +86-21-68383731 Fax: +86-21-68383731
Received: March 12, 2019 Peer-review started: March 15, 2019 First decision: July 31, 2019 Revised: September 2, 2019 Accepted: September 13, 2019 Article in press: September 13, 2019 Published online: October 15, 2019 Processing time: 218 Days and 19.6 Hours
ARTICLE HIGHLIGHTS
Research motivation
Our results demonstrated that high-grade tumor budding was related to poor 5-year overall survival (OS) in patients with gastric cancer (GC). Tumor budding may be a new prognostic indicator in GC.
Research objectives
This meta-analysis was carried out to clarify the prognostic and pathological impact of tumor budding in patients with GC.
Research methods
The PubMed, EMBASE, Web of Science, and the Cochrane Library databases were searched. The data were extracted, and statistical analysis was conducted using STATA 15.0 software to assess the clinicopathological features and OS related to tumor budding in patients with GC. The odds ratios (ORs) were presented for dichotomous variables with 95% confidence intervals (CIs), and the HR was presented for time-to-event variables with 95%CIs.
Research results
Our meta-analysis suggested that high-grade tumor budding was significantly associated with tumor stage (OR = 6.63, 95%CI: 4.01-10.98, P < 0.01), undifferentiated tumor status (OR = 3.74, 95%CI: 2.68-5.22, P < 0.01), lymphovascular invasion (OR = 7.85, 95%CI: 5.04-12.21, P < 0.01), and lymph node metastasis (OR = 5.75, 95%CI: 3.20-10.32, P < 0.01). Moreover, high-grade budding predicted poor 5-year OS (HR = 1.79, 95%CI: 1.53-2.05, P < 0.01) in patients with GC and poor 5-year OS (HR = 1.93, 95%CI: 1.45-2.42, P < 0.01) in patients with intestinal-type GC.
Research conclusions
This research is the first to demonstrate that high-grade tumor budding is related to poor 5-year OS and aggressive clinicopathological features in patients with GC.
Research perspectives
In this meta-analysis, the close relationship between poor prognosis in GC and tumor budding was demonstrated, and it was found that intestinal-type GC is more closely related to tumor budding, and related research on diffuse GC is lacking. In the future, we will study the relationship between diffuse GC and tumor budding using our own sample library, and determine the underlying mechanism of the relationship between tumor budding and poor prognosis.
