The adverse prognostic effect of tumor budding on the evolution of cutaneous head and neck squamous cell carcinoma.
BACKGROUND
Tumor budding is a readily detectable histopathologic feature that has been recognized as an adverse prognostic factor in several human cancers.


OBJECTIVE
We sought to assess the correlation of tumor budding with the clinicopathologic features and the prognostic value of tumor budding in cutaneous squamous cell carcinoma (cSCC).


METHODS
Forty-nine primary nonmetastatic and 49 primary metastatic cSCCs to regional lymph nodes were retrospectively studied. Statistical analyses were carried out to assess the relationship between tumor budding, clinicopathologic parameters, and patient survival.


RESULTS
Tumor budding was observed in 45 cases of 98 (46%). High-intensity budding (≥5 tumor buds) was observed in 20 tumors. Presence of tumor buds was a significant risk factor for nodal metastasis with crude and adjusted hazard ratios (HRs) of 8.92 (95% CI, 4.39-18.1) and 6.93 (95% CI, 3.30-14.5), respectively, and for reduced overall survival time (crude and adjusted HRs of 2.03 [95% CI, 1.26-3.28] and 1.72 [95% CI, 1.05-2.83], respectively).


CONCLUSIONS
This was a retrospective study limited to cSCCs of the head and neck. Examined tumors were >2 mm thick, and all were from a primary excision.


CONCLUSIONS
These results indicate an increased frequency of nodal metastasis and risk of death in patients with tumor buds.
Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain.
Miriam
M
Gonzalez-Guerrero
Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire; Universidad Autónoma de Chile, Santiago, Chile.
Pablo
P
Martínez-Camblor
Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain; Unit of Dermatopathology, Hospital Universitario Central de Asturias, Oviedo, Spain.
Blanca
B
Vivanco
Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain.
Ivan
I
Fernández-Vega
Service of Dermatology II, Hospital Universitario Central de Asturias, Oviedo, Spain.
Pablo
P
Munguía-Calzada
Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain.
Maria Paz
MP
Gonzalez-Gutierrez
Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Spain.
Juan Pablo
JP
Rodrigo
Service of Dermatology II, Hospital Universitario Central de Asturias, Oviedo, Spain.
Cristina
C
Galache
Unit of Dermatopathology, Hospital Universitario Central de Asturias, Oviedo, Spain; Service of Dermatology II, Hospital Universitario Central de Asturias, Oviedo, Spain. Electronic address: jorgesantosjuanes@gmail.com.
Jorge
J
Santos-Juanes
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate
head and neck; metastasis; squamous cell carcinoma