title: Tumour border configuration in colorectal cancer: proposal for an alternative scoring system based on the percentage of infiltrating margin.
abstract: OBJECTIVE
  Information on tumour border configuration (TBC) in colorectal cancer (CRC) is currently not included in most pathology reports, owing to lack of reproducibility and/or established evaluation systems. The aim of this study was to investigate whether an alternative scoring system based on the percentage of the infiltrating component may represent a reliable method for assessing TBC.
  
  
  RESULTS
  Two hundred and fifteen CRCs with complete clinicopathological data were evaluated by two independent observers, both 'traditionally' by assigning the tumours into pushing/infiltrating/mixed categories, and alternatively by scoring the percentage of infiltrating margin. With the pushing/infiltrating/mixed pattern method, interobserver agreement (IOA) was moderate (κ = 0.58), whereas with the percentage of infiltrating margins method, IOA was excellent (intraclass correlation coefficient of 0.86). A higher percentage of infiltrating margin correlated with adverse features such as higher grade (P = 0.0025), higher pT (P = 0.0007), pN (P = 0.0001) and pM classification (P = 0.0063), high-grade tumour budding (P < 0.0001), lymphatic invasion (P < 0.0001), vascular invasion (P = 0.0032), and shorter survival (P = 0.0008), and was significantly associated with an increased probability of lymph node metastasis (P < 0.001).
  
  
  CONCLUSIONS
  Information on TBC gives additional prognostic value to pathology reports on CRC. The novel proposed scoring system, by using the percentage of infiltrating margin, outperforms the 'traditional' way of reporting TBC. Additionally, it is reproducible and simple to apply, and can therefore be easily integrated into daily diagnostic practice.
authors: Institute of Pathology, Clinical Pathology Division, University of Bern, Bern, Switzerland.|Translational Research Unit, University of Bern, Bern, Switzerland.
authors: Eva
authors: E
authors: Karamitopoulou
authors: Translational Research Unit, University of Bern, Bern, Switzerland.
authors: Inti
authors: I
authors: Zlobec
authors: Institute of Pathology, Clinical Pathology Division, University of Bern, Bern, Switzerland.|Translational Research Unit, University of Bern, Bern, Switzerland.
authors: Viktor Hendrik
authors: VH
authors: Koelzer
authors: Institute of Pathology, Clinical Pathology Division, University of Bern, Bern, Switzerland.|Translational Research Unit, University of Bern, Bern, Switzerland.
authors: Rupert
authors: R
authors: Langer
authors: Institute of Pathology, Clinical Pathology Division, University of Bern, Bern, Switzerland.|Translational Research Unit, University of Bern, Bern, Switzerland.
authors: Heather
authors: H
authors: Dawson
authors: Institute of Pathology, Clinical Pathology Division, University of Bern, Bern, Switzerland.|Translational Research Unit, University of Bern, Bern, Switzerland.
authors: Alessandro
authors: A
authors: Lugli
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D016016:Proportional Hazards Models
keywords: colorectal cancer; prognosis; tumour border configuration