A novel tumor budding and cell nest size-based grading system outperforms conventional methods in vulvar squamous...

Area of Science:

• Oncology
• Pathology

Background:

• The tumor budding and tumor cell nest size (TBNS) grading scheme is an emerging prognostic indicator for squamous cell carcinoma (SCC).
• Its prognostic significance in vulvar SCC (VSCC) is not well-established.

Purpose of the Study:

• To evaluate the prognostic value of the TBNS grading system in surgically resected vulvar squamous cell carcinoma (VSCC).
• To compare the efficacy of the TBNS grading system against conventional grading systems in VSCC.

Main Methods:

• Applied the TBNS grading system to a cohort of 62 surgically resected VSCC cases.
• Excluded patients receiving neoadjuvant chemotherapy or with FIGO stage IA disease.
• Analyzed associations between TBNS grade, clinicopathologic features, overall survival (OS), and disease-free survival (DFS).

Main Results:

• High TBNS grade was significantly associated with reduced OS and DFS in VSCC.
• High TBNS grade correlated with adverse features: lymphovascular invasion, perineural involvement, lymph node metastasis, and advanced FIGO stage.
• Multivariate analysis confirmed TBNS grade 3 as an independent predictor of reduced DFS.

Conclusions:

• The TBNS grading system is a promising prognostic indicator for VSCC.
• The TBNS system demonstrated superior prognostic performance compared to conventional grading systems in this cohort.
• Further validation in larger cohorts is recommended to broaden clinical application.