ArticleThe American journal of surgical pathology2012
New criteria for histologic grading of colorectal cancer.
Article in The American journal of surgical pathology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 112 papers, 2 of them syntheses that pooled it.
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Who cites it
112 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Use of artificial intelligence for the prediction of lymph node metastases in early-stage colorectal cancer: systematic review.BJS open · 2024Pooled it
- Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2017Guideline
- Prediction of lymph node metastasis in early colorectal cancer based on histologic images by artificial intelligence.Scientific reports · 2022Trial
- Optimal Criteria for G3 (Poorly Differentiated) Stage II Colon Cancer: Prospective Validation in a Randomized Controlled Study (SACURA Trial).The American journal of surgical pathology · 2020Trial
- Article
- A modified CAP-based grading system incorporating non-tubular components for prognostic stratification in pancreatic ductal adenocarcinoma.Virchows Archiv : an international journal of pathology · 2026Article
- Poorly differentiated clusters surpass tumor budding as novel prognostic factors in pancreatic cancer, especially in cases treated with neoadjuvant chemotherapy.BMC gastroenterology · 2026Article
- Interobserver variability of histopathological assessment in pT1 colorectal carcinoma.Histopathology · 2026Article
- CDX2 expression dynamics in tumor clusters: a morpho-molecular biomarker in rectal cancer pretreatment biopsies revealed by sequential immunofluorescence.Scientific reports · 2026Article
- Prognostic significance and clinicopathological association of tumor budding and poorly differentiated clusters in cutaneous malignant melanoma.Virchows Archiv : an international journal of pathology · 2026Article
- Aligning computational pathology with clinical practice for colorectal cancer.NPJ precision oncology · 2025Review
- Differentiation grade is highly concordant between matched primary and metastatic colorectal cancer.Clinical & experimental metastasis · 2025Article
- The value and application of a poorly differentiated cluster-based Ezrin marginal score system in the prognostic assessment of colorectal cancer.Discover oncology · 2025Article
- TWEAK/Fn14 Drives Tumor Progression and Is Associated With Poor Survival of Colorectal Liver Metastases With Replacement Growth Patterns.Cancer medicine · 2025Article
- Tumor budding and poorly differentiated clusters as a biological continuum in colorectal cancer invasion and prognosis.Scientific reports · 2025Article
- Self-supervised learning reveals clinically relevant histomorphological patterns for therapeutic strategies in colon cancer.Nature communications · 2025Article
- Optimizing Prognostic Assessment in High-Risk Head and Neck Squamous Cell Carcinomas: The Impact of Tumor Budding and a Novel Histomorphological Scoring System.Cancer medicine · 2025Article
- Comparison of the prognosis and lymph node metastasis between no tumor budding and low-grade tumor budding in T1 and T2 colorectal cancer.Scientific reports · 2025Article
- Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal Cancer.Journal of the anus, rectum and colon · 2025Article
- Evaluation of Applicability of Tumor Budding and Poorly Differentiated Clusters as Additional Prognostic Markers in Colorectal Cancers.South Asian journal of cancer · 2024Article
52 more citing papers are in PubMed but not listed here.
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12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Conventional tumor grading systems based on the degree of tumor differentiation may not always be optimal because of difficulty in objective assessment and insufficient prognostic value for decision making in colorectal cancer (CRC) treatment. This study aimed to determine the importance of assessing the number of poorly differentiated clusters as the primary criterion for histologic grading of CRC. Five hundred consecutive patients with curatively resected stage II and III CRCs (2000 to 2005) were pathologically reviewed. Cancer clusters of ≥5 cancer cells and lacking a gland-like structure were counted under a ×20 objective lens in a field containing the highest number of clusters. Tumors with <5, 5 to 9, and ≥10 clusters were classified as grade (G)1, G2, and G3, respectively (n=156, 198, and 146 tumors, respectively). Five-year disease-free survival rates were 96%, 85%, and 59% for G1, G2, and G3, respectively (P<0.0001). Poorly differentiated clusters affected survival outcome independent of T and N stages and could help in more effective stratification of patients by survival outcome compared with tumor staging (Akaike information criterion, 1086.7 vs. 1117.0; Harrell concordance index, 0.73 vs. 0.67). The poorly differentiated cluster-based grading system showed a higher weighted κ coefficient for interobserver variability (5 observers) compared with conventional grading systems (mean, 0.66 vs. 0.52; range, 0.55 to 0.73 vs. 0.39 to 0.68). Our novel histologic grading system is expected to be less subjective and more informative for prognostic prediction compared with conventional tumor grading systems and TNM staging. It could be valuable in determining individualized postoperative CRC treatment.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.