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Tumour border configuration in colorectal cancer: proposal for an alternative scoring system based on the percentage of infiltrating margin
Author(s) -
Karamitopoulou Eva,
Zlobec Inti,
Koelzer Viktor Hendrik,
Langer Rupert,
Dawson Heather,
Lugli Alessandro
Publication year - 2015
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12665
Subject(s) - medicine , colorectal cancer , intraclass correlation , lymphovascular invasion , margin (machine learning) , lymph node , cancer , radiogenomics , metastasis , scoring system , vascular invasion , pathology , oncology , radiology , computer science , clinical psychology , machine learning , radiomics , psychometrics
Aims 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 . Methods and results Two hundred and fifteen CRC s 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.