Pathologic evaluation of tumor budding as a prognostic factor for Stage I–II tongue squamous cell carcinoma

Tumor budding is a prognostic marker for overall survival and not for lymph node metastasis in Oral Squamous Cell Carcinoma – Systematic Review Update and Meta-Analysis

“…All the studies of this systematic review showed low risk of bias in the ‘study participation’ as well as ‘prognostic factor measurement’ domains. All included studies showed low risk of bias in this domain, except few studies such as Farhadi et al (2017), 27 Hong et al (2018), 28 Mohan et al (2018), 31 Okuyama et al (2018), 32 Yamanouchi et al (2018) 37 showed high risk of bias as the details regarding outcome measures have not be mentioned in the article, whereas Yamada et al 36 showed moderate risk of bias. 27 , 28 , 31 , 32 , 36 , 37 For the domain of ‘other prognostic factors’, all the studies exhibited low risk of bias.…”

“…The age range of the patients included ranged from 15 to 100 years, 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 in majority of the studies males were affected more than females, except few studies which showed female predominance. 10 , 22 , 30 , 35 The location of OSCC included in most studies were predominantly related to tongue 5 , 10 , 15 , 17 , 20 , 22 , 23 , 24 , 25 , 26 , 28 , 35 followed by other site such as buccal mucosa, floor of mouth, lip, palate etc.…”

“… 10 , 22 , 30 , 35 The location of OSCC included in most studies were predominantly related to tongue 5 , 10 , 15 , 17 , 20 , 22 , 23 , 24 , 25 , 26 , 28 , 35 followed by other site such as buccal mucosa, floor of mouth, lip, palate etc. 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 Only one study each considered certain unusual sites such as mandibular gingiva 32 and gingivo-buccal complex in particular. 30 …”

“… 10 The evaluation was done on routine hematoxylin and eosin (H & E) section along with cytokeratin IHC in most of studies, however few studies did it only on H & E stained sections alone with the field of evaluation at 20X magnification in most of the studies. 21 , 23 , 24 , 27 , 30 , 31 , 34 , 36 , 37 , 38 , 40 Tumor budding evaluation method most commonly used was according to Wang et al i.e., <5 buds is considered as low intensity tumor budding and >5 buds as high intensity tumor budding. 5 …”

“…Occurrence of TB in OSCC patients: The prevalence of TB ranged from 53 % to 89 % overall in all the selected studies. 9 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 The tumor budding (high Intensity) was seen to be linked with LNM, occult cervical lymph node metastasis, delayed neck metastasis, distant metastasis, depth of invasion, tumor size, cell differentiation, clinical stage, reduced overall survival, decreased disease free survival, poor prognosis and worst patient outcomes according to various studies. All the studies suggested that TB is a important and independent factor for prognosis especially with regards to LNM, 9 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 except one study by Manjula et al who concluded that this parameter has no role in LNM specifically in gingiva-buccal oral carcinoma.…”