Validation of the International Tumor Budding Consensus Conference (2016) recommendations in oral tongue squamous cell carcinoma

Abstract

Background Tumor budding is a valuable prognostic marker in oral tongue squamous cell carcinoma (OTSCC) but lacks a standardized scoring system. The aim of this study was to evaluate the prognostic value of tumor budding for OTSCC patients based on the scoring system recommended by the International Tumor Budding Consensus Conference (ITBCC) 2016. Methods Tumor budding was scored as ITBCC recommended in 255 patients with OTSCC. Then, associations between tumor budding and clinicopathologic parameters were examined. Among them, 136 patients with follow‐up data available were used to evaluate overall survival (OS) by the Kaplan‐Meier method. Prognostic value of tumor budding was assessed by Cox regression analysis. The inter‐observer and intra‐observer agreement was calculated by the kappa statistic. Results Tumor budding score was associated with lymph node metastasis, differentiation, invasive pattern, lymphoid infiltrate, tumor relapse, invasive depth, and reduced OS in OTSCC patients. The Cox analysis showed high budding score was an independent prognostic factor in patients with all clinical stage and patients with clinical early‐stage OTSCC. The high kappa values were achieved in intra‐observer and inter‐observer. Conclusions International Tumor Budding Consensus Conference scoring system is a simple, reliable, and reproducible method to measure tumor budding in OTSCC, which should be included in the routine pathological report.

Tumor budding score predicts lymph node status in oral tongue squamous cell carcinoma and should be included in the pathology report

“…The funder had no role in planning or execution of the study, nor in interpretation of results or writing of the manuscript. cells at the invasive front, and has been associated in many studies with lymph node metastasis, relapse, and accordingly poor prognosis [16][17][18][19][20][21][22]. In many studies, TB has been proposed to be a useful and significant prognostic marker that can be evaluated on hematoxylin and eosin (H&E)-stained sections, at low cost and with fair reproducibility [18,[23][24][25].…”

Hallmarks of cancer: Tumor budding as a sign of invasion and metastasis in head and neck cancer

“…2,12,37,54,59 High reproducibility has also been shown in many studies evaluating tumor budding in other cancers. In studies of tumor budding in HNSCC, good to excellent intraobserver and interobserver reproducibility has been widely reported.…”

“…In studies of tumor budding in HNSCC, good to excellent intraobserver and interobserver reproducibility has been widely reported. 2,12,37,54,59 High reproducibility has also been shown in many studies evaluating tumor budding in other cancers. 57,[62][63][64] This indicates eligibility of tumor budding to be routinely implemented in clinical reports.…”

“…2,8,9,11,12,20,27,34,40,45,48,54 This definition is in accordance with the recent recommendation by the International Tumor Budding Consensus Conference (ITBCC 2016) in colorectal cancer, 55 and also agrees with studies on other cancers. 37 Majority of studies that assessing tumor budding in HNSCC have used one high-power field (HPF) in which the invasive front scanned and area with highest number of tumor budding is counted and used to score the case. 37 Majority of studies that assessing tumor budding in HNSCC have used one high-power field (HPF) in which the invasive front scanned and area with highest number of tumor budding is counted and used to score the case.…”

“…56,57 Of note, a recent study has reported an excellent reproducibility and reliability of ITBCC 2016 scoring method in oral tongue cancer. 37 Majority of studies that assessing tumor budding in HNSCC have used one high-power field (HPF) in which the invasive front scanned and area with highest number of tumor budding is counted and used to score the case. 2,11,12,27,31,40,45,48,54,58 A method of 10 HPFs (where average score is considered) was recently applied by Boxberg et al 49 and this showed significant prognostic value in OSCC.…”