Related Experiment Video
Updated: Jun 13, 2026
Translationally-Relevant Tumor Resection Model for Murine Preclinical Models of Oral Squamous Cell Carcinoma
Published on: April 3, 2026
Tumor Budding Is a Promising Indicator for Elective Neck Dissection in Node-Negative Early-Stage Oral Squamous Cell
Zhuqin Xiang1,2,3, Bokai Yun1,2,3, Wenjin Wang1,2,3
1Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.
Background:
The optimal management of early-stage oral squamous cell carcinoma (OSCC) with clinically node-negative neck remains controversial. A reliable biomarker to stratify occult metastasis risk for elective neck dissection (END) is lacking.
Methods:
This retrospective cohort included 231 early-stage cN0 OSCC patients. Tumor budding (TB) was graded by ITBCC criteria. Survival was analyzed using Kaplan-Meier and Cox regression; subgroup and additive interaction were tested.
Results:
High-grade TB was found in 55.4% (128/231) and associated with poorer 5-year OS (80.4% vs. 93.0%, p = 0.0059) and DFS (66.2% vs. 80.6%, p = 0.019). END (67.5%, 156/231) independently improved OS (HR = 0.28, p < 0.001) and DFS (HR = 0.35, p = 0.003). In high-grade TB patients, END markedly raised 5-year OS (88.1% vs. 60.0%, p < 0.001) and DFS (76.2% vs. 39.8%, p < 0.001), with significant additive interaction (RERI = 7.12). No OS benefit was seen in low-TB patients.
Conclusion:
TB effectively stratifies END benefit. END is recommended for high-grade TB early stage cN0 OSCC, while watch-and-wait is suitable for low-grade TB patients.
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