Published online Oct 15, 2019. doi: 10.4251/wjgo.v11.i10.898
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
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.
This meta-analysis was carried out to clarify the prognostic and pathological impact of tumor budding in patients with GC.
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.
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.
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.
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.