IADR Abstract Archives
The Prognostic Role of Tumor Budding in Oral Tongue Cancer
Objectives: Oral tongue squamous cell carcinoma (OTSCC) represents the most common malignancy of the oral cavity characterized by a short-term survival rate <50%. Despite the improvements in prognostic stratification of the current staging system, its prognosis is poor and unpredictable. This emphasizes the critical need for a predictive model leading the clinical-therapeutic strategies. Accumulating evidence suggested tumor budding (TB) is a reliable prognostic factor in OTSCC. However, a standardized scoring system is necessary to its assessment.
The study aims to evaluate the prognostic role of TB in 210 OTSCC patients surgical treated at Ancona General Hospital between 1990-2015.
Methods: TB was evaluated on hematoxylin and eosin-stained sections in the hotspot area of the tumoral infiltrative front under X200 magnification. TB was scored using two-tier (cutoff: 3buds/x20; 5buds/x20) and three-tier systems (cutoff: <4buds/x20; 5-9buds/x20; ≥10buds/x20) and according to BD-model (DOI cutoff: 4mm; TB cutoff: 5buds/x20) and revised-Grading system (WHO Grading; TB cutoff: 5buds/x20). Univariate and multivariate Cox regression analyses of disease-specific survival (DSS) were performed. A p-values <0.05 was considered as statistically significant.
Results: On multivariate analysis, the two-tier (cutoff: 5buds/x20) and three-tier system resulted independent prognostic factors of worst DSS. High-risk patients had a 2.21 (≥5buds/x20) and 3.08 (≥10buds/x20) times-increased probability of poor DSS compared to low-risk group (<4buds/x20) (p=0.0000). It is significantly increased even for intermediate-risk patients (5-9buds/x20) (HR=1.83; p=0.0021). Furthermore, no statistically differences emerged classifying patients according to BD-model and revised-Grading.
Conclusions: These data confirm the prognostic value of TB in predicting DSS in OTSCC. Classifying patients in two groups using the 5buds cutoff significantly discriminates their survival outcomes. The TB integration in BD-model and revised-Grading does not improve the patient stratification. Since the established role of DOI in pTNM-staging and the poor prognostic value of WHO grading, TB could be implemented as a prognostic marker per se.
The study aims to evaluate the prognostic role of TB in 210 OTSCC patients surgical treated at Ancona General Hospital between 1990-2015.
Methods: TB was evaluated on hematoxylin and eosin-stained sections in the hotspot area of the tumoral infiltrative front under X200 magnification. TB was scored using two-tier (cutoff: 3buds/x20; 5buds/x20) and three-tier systems (cutoff: <4buds/x20; 5-9buds/x20; ≥10buds/x20) and according to BD-model (DOI cutoff: 4mm; TB cutoff: 5buds/x20) and revised-Grading system (WHO Grading; TB cutoff: 5buds/x20). Univariate and multivariate Cox regression analyses of disease-specific survival (DSS) were performed. A p-values <0.05 was considered as statistically significant.
Results: On multivariate analysis, the two-tier (cutoff: 5buds/x20) and three-tier system resulted independent prognostic factors of worst DSS. High-risk patients had a 2.21 (≥5buds/x20) and 3.08 (≥10buds/x20) times-increased probability of poor DSS compared to low-risk group (<4buds/x20) (p=0.0000). It is significantly increased even for intermediate-risk patients (5-9buds/x20) (HR=1.83; p=0.0021). Furthermore, no statistically differences emerged classifying patients according to BD-model and revised-Grading.
Conclusions: These data confirm the prognostic value of TB in predicting DSS in OTSCC. Classifying patients in two groups using the 5buds cutoff significantly discriminates their survival outcomes. The TB integration in BD-model and revised-Grading does not improve the patient stratification. Since the established role of DOI in pTNM-staging and the poor prognostic value of WHO grading, TB could be implemented as a prognostic marker per se.