A novel prognostic model for tongue squamous cell carcinoma based on the characteristics of tumour and its microenvironment: iBD score

Abstract

Aims Tumour budding and invasive depth can predict survival of patients with tongue squamous cell carcinoma (TSCC), while the prognostic value of tumour microenvironment (TME) remains unknown. Here, both characteristics of the tumour and its microenvironment were examined and a novel prognostic model has been proposed. Methods and results A total of 246 patients with TSCC were included. Using H&E‐stained sections, pathological parameters of tumour and the TME were assessed. Inflammatory response (i), tumour budding (B) and invasive depth (D) were combined as iBD score. The association between these variables and the patient survival was determined. Both tumour budding and inflammatory status were independent variables for predicting overall survival (OS) and disease‐free survival (DFS) of TSCC patients. Invasive depth was correlated with differentiation, T classification, lymph node metastasis, clinical stage and recurrence (P < 0.05). The novel iBD model was strongly correlated with T classification, lymph node metastasis, clinical stage and recurrence, and showed clear distinction of scores 0, 1 and 2. High iBD score had a strong association with reduced OS and DFS (P < 0.01). Conclusions The iBD scoring model is strongly associated with lymph node metastasis and recurrence in TSCC and could be a promising survival predictor for TSCC patients.

Hallmarks of cancer: Tumor budding as a sign of invasion and metastasis in head and neck cancer

“…29,[43][44][45] Budding and depth of invasion (BD) model was introduced a few years ago 43 and has recently been validated in subsequent studies. 29,[43][44][45] Budding and depth of invasion (BD) model was introduced a few years ago 43 and has recently been validated in subsequent studies.…”

“…29,[43][44][45] Budding and depth of invasion (BD) model was introduced a few years ago 43 and has recently been validated in subsequent studies. 29 Arora et al 45 introduced a grading model for early OSCC consisting of seven histopathologic parameters including tumor budding. 29 Arora et al 45 introduced a grading model for early OSCC consisting of seven histopathologic parameters including tumor budding.…”

“…Of note, our recent systematic search found 16 studies on tumor budding in OSCC and the meta-analysis confirmed the significance of tumor budding in prognostication of lymph node metastasis and survival. 10 Subsequently, after that meta-analysis many studies have been published indicating that tumor budding is a promising prognostic marker in OSCC, 21,[29][30][31][32] including the recent meta-analysis with tumors from various subsites of the head and neck. 33 In laryngeal cancer, Sarioglu et al 8 were the first to evaluate tumor budding in HNSCC and they reported the prognostic power of tumor budding to predict distant metastasis in laryngeal carcinoma.…”

“…Tumor budding has been recently suggested as a parameter in histopathologic grading systems of HNSCC and this is based on studies most of which focus on OSCC. 29,[43][44][45] Budding and depth of invasion (BD) model was introduced a few years ago 43 and has recently been validated in subsequent studies. [46][47][48] Yu et al proposed a grading system consisting of inflammatory response (i), tumor budding (B), and invasive depth (D) and this was introduced as the iBD score.…”

“…[46][47][48] Yu et al proposed a grading system consisting of inflammatory response (i), tumor budding (B), and invasive depth (D) and this was introduced as the iBD score. 29 Arora et al 45 introduced a grading model for early OSCC consisting of seven histopathologic parameters including tumor budding. Boxberg et al proposed a histopathologic grading system based on the evaluation of tumor budding and cell nest size in OSCC, 49 and later on the same system was applied for laryngeal and hypopharyngeal cancers and showed a significant prognostic impact.…”