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The Prognostic Significance of Tumor Budding and Cell Nest Size in Laryngeal Squamous Cell Carcinoma Publisher Pubmed



Anousha K1 ; Shekari MM1 ; Mirzaian E2 ; Yousefi T3 ; Beheshti A4 ; Lotfi M3, 4
Authors
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Authors Affiliations
  1. 1. Pathology Department, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Pathology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Pathology Department, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Cancer Reports Published:2024


Abstract

Background: Laryngeal squamous cell carcinoma (LSCC) is a commonly occurring malignancy in the head and neck region. However, due to the heterogeneity of primary tumor sites, tumor behavior, and molecular mechanisms, there is currently no consensus on the accuracy of clinicopathological prognostic factors for individual cases. Tumor histopathologic behavior remains a crucial factor in predicting aggressiveness. Recent studies have shown that peritumoral tumor budding (TB) combined with cell nest size (CNS) is a reliable marker for predicting lymph node metastasis, advanced cancer prognosis, and therapeutic response in SCCs of different origins. Aims: This study aims to investigate the relationship between TB and CNS in the context of nodal metastasis and overall prognosis in patients diagnosed with LSCC. Our objective is to establish the significance of TB and CNS status as a cost-effective, easily assessed, and highly reliable prognostic factor among this patient population. Methods and results: In this retrospective cross-sectional study, we analyzed 128 LSCC cases that underwent total laryngectomy at Amir Alam Hospital. We evaluated TB and CNS based on the Boxberg et al. study. Our study demonstrated a significant correlation between TB, and nodal involvement (p = 0.015), vascular invasion (p = 0.035), and mortality rate (p = 0.001), as well as a significant statistical correlation between high TB and extra-laryngeal extension (p = 0.006), clinical stage (p = 0.011), and mortality rate (p = 0.001). Moreover, small nest size was also associated with the clinical stage (p = 0.047), extra-laryngeal extension (p = 0.015), and mortality rate (p < 0.001). Based on our results, TB, CNS, and clinical stage are independent prognostic factors for mortality rate and are correlated with disease-specific survival. Conclusion: Given the effect of TB and CNS on the overall prognosis and survival of patients with LSCC, evaluating these two factors on routine H&E microscopic examination of LSCC specimens is recommended to facilitate individualized risk assessment and treatment planning. © 2024 The Author(s). Cancer Reports published by Wiley Periodicals LLC.