PROGNOSTIC AND PREDICTIVE IMPORTANCE OF TUMOR BUDDING, LYMPHOVASCULAR AND PERINEURAL INVASION IN COLORECTAL CARCINOMA
Altin SALLAHU, Ferat SALLAHU
Abstract
Background: Colorectal carcinoma (CRC) remains one of the most common malignant neoplasms worldwide and a leading cause of cancer-related mortality. Accurate identification of prognostic markers is essential for predicting recurrence and stratifying patients for individualized treatment. This study aimed to evaluate the prognostic and predictive significance of tumor budding (TB), lymphovascular invasion (LVI), and perineural invasion (PNI) in colorectal carcinoma. Methods: This retrospective observational cohort study included 243 patients with histologically confirmed colorectal adenocarcinoma treated at the University Clinical Center of Kosovo (UCCK) between January 2020 and December 2024. Clinical and pathological data were collected, including TB, LVI, and PNI. Statistical analysis included descriptive statistics, chi-square tests, binary logistic regression, receiver operating characteristic (ROC) curve analysis with area under the curve (AUC), and Kaplan–Meier disease-free survival (DFS) analysis with log-rank tests. Results: High tumor budding (BD3) was present in 29.2% of patients, lymphovascular invasion in 34.1%, and perineural invasion in 26.7%. At least one invasive histopathological factor was identified in 48.6% of patients. All three parameters were significantly associated with tumor recurrence (p < 0.001). Logistic regression analysis identified LVI (OR 4.72; 95% CI 2.46–9.03), PNI (OR 3.91; 95% CI 1.98–7.72), and tumor budding (OR 3.24; 95% CI 1.67–6.29) as independent predictors of recurrence. ROC analysis demonstrated the highest predictive value for LVI (AUC = 0.781). Patients with more than one invasive factor showed significantly reduced disease-free survival (21.6 vs. 33.2 months; p < 0.001). Conclusion: Lymphovascular invasion, perineural invasion, and tumor budding represent independent prognostic histopathological factors in colorectal carcinoma. LVI demonstrated the strongest predictive value for recurrence. These parameters should be routinely included in pathological reports and integrated into prognostic models to improve individualized risk assessment and therapeutic decision-making.
Pages: 84 - 90