Tumour budding is an independent predictive factor of cutaneous squamous-cell carcinoma aggressiveness

Abstract

Background/Aim: Tumour budding (TB), i.e. The presence of groups of ≤5 tumour cells ahead of the invasive tumour front, is a pathological feature associated with an aggressive outcome in several cancer types. The aim of this study was to assess the value of TB as an independent prognostic factor of cutaneous squamous cell carcinomas (cSCC). Materials and Methods: We studied 25 cases of aggressive cSCC (defined as tumours that developed local recurrences and/or metastases after adequate excision) and 27 cases of non-aggressive cSCC. TB was expressed as the mean number of tumour buds in 5 adjacent high-power fields (HPF). Results: Statistical analysis showed that TB is an independent predictive factor of cSCC aggressiveness. When the cut-off value of 0.8 buds/HPF was considered, the positive and negative predictive values for cSCC aggressiveness reached 77.3% and 75.0%, respectively. Conclusion: As with other cancer types, TB appears to be a new independent pathological factor of aggressiveness of cSCC, providing a new tool to predict cSCC outcome, similar to other already established features associated with an adverse outcome (such as tumour size).