Impact of the International Tumor Budding Consensus Conference Recommendations in Oral Cancer

Objectives: Tumor budding was suggested as a valuable prognostic factor in oral squamous cell carcinoma (OSCC) but lacks a standardized scoring system. This study evaluates tumor budding in OSCC using the scoring system recommended by the International Tumor Budding Consensus Conference (ITBCC) 2016.

Materials and methods: The study included 114 patients with resected OSCC. Tumor budding was evaluated according to ITBCC criteria and assigned to three categories (low, intermediate, and high tumor budding). The associations between tumor budding and clinicopathological parameters were examined and survival rate analyses were performed by the Kaplan-Meier method. The prognostic value of tumor budding was assessed by Cox regression analysis.

Results: Significant correlations of tumor budding with clinicopathological parameters including lymph node metastasis, grade, stage, perineural and lymphovascular invasion, and local recurrence were found. Intermediate and high tumor budding were significantly and independently associated with worse disease-free survival. High tumor budding was identified as an independent prognostic factor for disease-specific and overall survival.

Conclusions: The ITBCC scoring system represents a simple, feasible, and reproducible method to evaluate tumor budding in OSCC. Tumor budding, according to ITBCC criteria, showed its prognostic value in resected OSCC, and its incorporation into the histopathological reporting guidelines should be considered.