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Published on: April 20, 2018
Intratumoral Budding in Preoperative Biopsies of Oral Squamous Cell Carcinoma: Prognostic Value in Comparison With
R Keerthika1, Akhilesh Chandra1, Rahul Agarwal1
1Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Background:
Oral squamous cell carcinoma (OSCC) requires reliable prognostic markers for treatment planning. Intratumoral budding (ITB) is a histopathological parameter shown to have prognostic relevance in several malignancies. This study evaluated the prognostic utility of ITB in pre-operative OSCC biopsies compared with World Health Organization (WHO) histological grading.
Methods:
An ambispective cohort of 42 pre-operative OSCC cases (well and moderately differentiated squamous cell carcinoma) with corresponding resection reports (January 2022-April 2025) was analyzed. ITB was assessed on hematoxylin and eosin-stained sections using International Tumor Budding Consensus Conference criteria, including TB0. Clinicopathological parameters and survival outcomes-disease-free survival (DFS) and overall survival (OS)-were evaluated.
Results:
ITB positivity correlated significantly with higher nodal stage, tumor-node-metastasis stage, depth of invasion, perineural invasion, and extracapsular spread (all p < 0.05). ITB-positive cases showed reduced DFS (p = 0.023) and OS (p = 0.019), with worsening DFS across increasing ITB grades (p = 0.018). Cox regression demonstrated higher hazard ratios for ITB positivity (DFS: HR 47.93, 95% CI 0.12-18,571.86; OS: HR 49.80, 95% CI 0.14-18,238.87), though not statistically significant. WHO grading showed no significant survival associations.
Conclusion:
In this single-center, small cohort, ITB demonstrated stronger associations with adverse features and survival than WHO grading, warranting validation in larger cohorts.
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