Soriano LL, et al. - Whether “tumor budding” (TB) is a poor prognostic factor in muscle-invasive bladder carcinoma (MIBC), was investigated in this retrospective analysis of 106 patients with MIBC who underwent radical cystectomy. Researchers applied a cytokeratin AE1/AE3 immunostaining to identify and quantify TB via the “hot-spot” method. They found that cancer-specific mortality in MIBC was independently predicted by TB, with a cut-off point of 14 “buds.” The “low-grade TB” group (≤14 “buds”) and the “high-grade TB” group (>14 “buds”) had a median survival rate of 69.5 months and 18.5 months, respectively. The risk of mortality was 2.27 times more in patients with more than 14 “buds”. With the increase in the number of “buds”, a progressive increase in the mortality risk was evident, at a rate of 2% per “bud.”