In stage II colorectal carcinoma (CRC), adjuvant chemotherapy is reserved to cases at high risk of adverse outcome. This study aims to investigate the prognostic value of tumor budding (TB) and poorly differentiated clusters (PDC) in this setting. In a cohort of 149 patients with surgically resected stage II CRC not undergoing neoadjuvant or adjuvant treatments, we assessed the prognostic value of several clinical-pathological variables, including PDC and TB, on cancer-specific survival (CSS). Rectal location, lymphovascular invasion, and a number of lymph nodes < 12 confirmed to be significant and independent predictors of shorter CSS. A total of 117 CRCs were graded as PDC-G1 (0–4 PDCs), 19 as PDC-G2 (5–9 PDCs), and 13 as PDC-G3 (> 9 PDCs). Ninety-eight cases had PDC absent. TB foci were found in 91 CRCs; 121 were classified Bd1, 16 were Bd2, and 12 were Bd3. PDC-G2/G3 was significantly prognostic of shorter CSS (P < 0.0001). Among PDC-G1 cases, the presence of PDC was significantly associated with reduced CSS (P < 0.0001). Moreover, in the whole 149 CRCs, it had higher sensitivity and specificity to identify high-risk patients, compared to PDC grade, and it was independently associated with shorter CSS at multivariate analysis. High TB grade (Bd3) was significantly associated with shorter CSS (P = 0.0001), but it lost prognostic value at multivariate analysis. These findings suggest that the presence of PDC in stage II CRCs might be added to the pool of high-risk factors, warranting the use of adjuvant chemotherapy.

在II期大肠癌（CRC）中，辅助化疗仅适用于具有高不良反应风险的病例。这项研究旨在调查在这种情况下的肿瘤萌芽（TB）和低分化簇（PDC）的预后价值。在149例未接受新辅助或辅助治疗的手术切除的II期CRC患者中，我们评估了包括PDC和TB在内的几种临床病理变量对癌症特异性生存（CSS）的预后价值。直肠位置，淋巴管浸润和<12的淋巴结数目被证实是较短CSS的重要且独立的预测因素。总共117个CRC分为PDC-G1（0-4个PDC），19个PDC-G2（5-9个PDC）和13个PDC-G3（> 9个PDC）。98例没有PDC。在91个CRC中发现了结核病灶；121被分类为Bd1，Bd2为16，Bd3为12。PDC-G2 / G3对较短CSS的预后显着（P  <0.0001）。在PDC-G1病例中，PDC的存在与CSS降低显着相关（P  <0.0001）。此外，在全部149例CRC中，与PDC分级相比，它具有更高的敏感性和特异性来识别高危患者，并且在多变量分析中它与较短的CSS独立相关。高结核等级（Bd3）与较短的CSS显着相关（P  = 0.0001），但在多变量分析中失去了预后价值。这些发现表明，II期CRC中PDC的存在可能会增加高危因素库，从而有必要使用辅助化疗。