Kim HN, Lee SY, Kim BH, et al. - Researchers explored the clinicopathological implications as well as the applicability of tumor budding (TB), measured employing the International Tumor Budding Consensus Conference (ITBCC) scoring system, in gallbladder cancer (GBC). There were 78 GBC patients with TB grades assigned as follows: Bd1 (low TB), 41 (52.6%) patients; Bd2 (intermediate TB), 22 (28.2%) patients; and Bd3 (high TB), 15 (19.2%) patients. In univariate Cox regression analysis, factors related to worse 5-year overall survival and disease-free survival included: a poor histological grade, high pT category, lymphatic invasion, perineural invasion, and intermediate to high TB grades. Multivariate Cox analysis revealed absence of a significant association of TB with death or recurrence risk. There was a substantial interobserver agreement of TB grading. For the first time ever, the ITBCC scoring system was applied and findings indicated that TB has prognostic value in GBC.