title: Tumour budding with and without admixed inflammation: two different sides of the same coin?
abstract: BACKGROUND
  Tumour budding is an adverse prognostic indicator in colorectal cancer (CRC). Marked overall peritumoural inflammation has been associated with favourable outcome and may lead to the presence of isolated cancer cells due to destruction of invading cancer cell islets.
  
  
  METHODS
  We assessed the prognostic significance of tumour budding and peritumoural inflammation in a cohort of 381 patients with CRC applying univariate and multivariate analyses.
  
  
  RESULTS
  Patients with high-grade budding and marked inflammation had a significantly better outcome compared with patients with high-grade budding and only mild inflammation. Outcome in these cases, however, was still worse compared with cases with low-grade budding, in which the extent of peritumoural inflammation had no further prognostic effect.
  
  
  CONCLUSIONS
  Tumour budding proved to be a powerful prognostic variable in patients with CRC. Scattering of invading cancer cell islets by marked overall peritumoural inflammation seems to have a minor role.
authors.affiliation: Institute of Pathology, Medical University, Auenbruggerplatz 25, 8036 Graz, Austria.
authors.forename: Nicole
authors.initials: N
authors.lastname: Max
authors.affiliation: Department of Oncology, Haematology, BMT with Section Pneumology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Harbaum
authors.affiliation: Institute of Pathology, Medical University, Auenbruggerplatz 25, 8036 Graz, Austria.
authors.forename: Marion J
authors.initials: MJ
authors.lastname: Pollheimer
authors.affiliation: Department of Surgery, Medical University of Innsbruck, Innrain 52, 6020 Innsbruck, Austria.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Lindtner
authors.affiliation: Department of Surgery, Medical University, Auenbruggerplatz 29 8036, Graz, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Kornprat
authors.affiliation: Institute of Pathology, Medical University, Auenbruggerplatz 25, 8036 Graz, Austria.
authors.forename: Cord
authors.initials: C
authors.lastname: Langner
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D008297:Male; D009361:Neoplasm Invasiveness; D011379:Prognosis