Validation of Tumor Budding as a Prognostic Factor in Ovarian Clear Cell Carcinoma Using an Independent Cohort

Ovarian clear cell carcinoma (OCCC) is an endometriosis-related neoplasm, in which traditional histologic grading does not show prognostic significance. Tumor budding was associated with poorer outcomes in OCCC in previous studies. We aimed to evaluate the prognostic significance of tumor budding in OCCC in an independent cohort. Seventy patients diagnosed with OCCC were retrospectively identified. Slides from primary ovarian resections were reviewed by 2 pathologists blinded to outcomes. Tumor budding was defined as single or clusters of <5 tumor cells in peritumoral and/or intratumoral nonhyalinized stroma. Most patients were diagnosed at an early stage (stage I: 69%; II: 20%; III: 10%; IV: 1%). Twenty-one patients experienced recurrences (30%) and 2 progressive disease (3%). At the last follow-up, 52 patients had no evidence of disease, 6 were alive with disease, and 12 died of disease. The median follow-up time was 66.7 mo. Tumor budding was identified in 41 cases (59%) with a kappa coefficient of 0.60. On univariate analysis, tumor budding (P=0.022) and stage (P=0.0005) were associated with shorter progression-free survival (PFS), but only stage was independently associated with shorter PFS on multivariate analysis (P=0.003). Higher stage was the only variable associated with shorter overall survival (P=0.037). Tumor budding was associated with higher stage (P=0.039), absence of endometriosis (P=0.042) and adenofibroma (P=0.046), tumor-associated inflammation (P=0.002), and higher mitotic activity (P=0.022). There was no association between tumor budding and molecular characteristics in 32 cases with somatic tumor sequencing. Tumor budding was not independently associated with worse outcomes in this cohort of OCCC, although it was significantly associated with specific clinicopathologic features, including higher stage. Stage was the only independent variable predictive of poorer survival, which appears to drive the prognostic significance of tumor budding. Validation of Tumor Budding as a Prognostic Factor in Ovarian Clear Cell Carcinoma Using an Independent Cohort - Buy - SDC Plain Language SummaryThis study examined the role of tumor budding in predicting outcomes for ovarian clear cell carcinoma (OCCC), a cancer linked to endometriosis. Researchers analyzed 70 patient cases, finding tumor budding in 59% of them. While tumor budding was linked to poorer progression-free survival and higher cancer stage, only the stage of cancer independently predicted survival outcomes. Tumor budding was associated with specific features like absence of endometriosis and higher mitotic activity, but not with molecular characteristics. Overall, cancer stage was the key factor in determining survival, suggesting tumor budding's prognostic value is influenced by stage. Text is machine generated and may contain inaccuracies. FAQ