The effect of tumor budding index on clinical parameters in early-stage oral cavity cancers

Tumor budding is an established prognostic marker in colorectal cancer however, it is not routinely incorporated into risk assessment in oral cavity squamous cell carcinoma.

To evaluate the impact of tumor budding on survival outcomes and lymph node metastasis in patients with oral cavity cancer undergoing surgical treatment.

Between January 1, 2010 and January 1, 2021, 87 patients diagnosed with oral cavity cancer and who underwent surgery at our clinic were included in the study. Clinically T_1-2 was observed in 60 patients (69%), T_3-4 in 27 patients (31%), and neck dissection was not performed in 8 patients with T₁N₀M₀ due to comorbidities.

The most common site was the tongue in 61 cases (70.1%), followed by the buccal mucosa in 15 cases (17.2%). The median follow-up period was 46.5 months (0.3-160.9). Tumor budding was identified as an independent predictor of overall survival, disease-free survival, and lymph node metastasis in early-stage oral cavity squamous cell carcinoma.

The presence of budding was associated with an increased risk of lymph node metastasis and shorter overall and disease-free survival.

Routine assessment of tumor budding may contribute to postoperative risk classification and follow-up planning, beyond staging parameters.