1It is of great clinical importance to identify simple prognostic markers from preoperative 2 biopsies that could guide treatment planning. Here, we compared tumor budding (B), depth 3 of invasion (D) and the combined scores (i.e. BD histopathologic model) in preoperative 4 biopsies and the corresponding postoperative specimens of oral tongue squamous cell 5 carcinoma (OTSCC). Tumor budding and depth of invasion were evaluated in the pre-and 6 postoperative samples from 100 patients treated for OTSCC. Sensitivity and specificity 7 statistics were used. Our results showed statistically significant (P< 0.001) relationship 8 between pre-and postoperative BD scores. There was an agreement between the pre-and 9 postoperative BD model scores in 83 cases (83%) with 57.1% sensitivity (95% CI: 39.4% 10 to 73.7%) and 96.9% specificity (95% CI: 89.3% to 99.6%). Our findings suggest that the 11 BD model, analyzed from representative biopsies, could be used for the treatment planning 12 of OTSCC. 13 14 15

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