Evaluation of tumor budding and lymphocytic inflammatory response against tumor in cutaneous squamous cell carcinomas of the head and neck region, comparison with other histopathological prognostic parameters

Although the relationship between tumor budding (TT) and lymphocytic response to tumor (TKGLY) with prognostic factors such as mortality, metastasis or disease-free survival has been shown in various studies, the prognostic value of both parameters in cutaneous squamous cell carcinomas (cSCC) of the head and neck region is unknown. In this study, we investigated the relationship between TT, TKGLY and the prognostic factors defined in head and neck cSCC. The patients who were diagnosed with cSCC in the head and neck region between 2010-2021 were included in the study. Demographic and histological characteristics of the patients were recorded. The patients were divided into 3 groups according to their TT grades and 3 groups according to the TKGLY pattern. Afterwards, the relationship of both parameters with demographic and histological parameters was examined. 187 patients were included in the study. 118 patients were in the grade-1 TT group, 58 patients were in the grade-2 TT group, and 11 patients were in the grade-3 TT group. 105 patients were included in the TKGLY pattern-1, 74 patients in the TKGLY pattern-2, and 8 patients in the TKGLY pattern-3 group. While there is statistical significance between TT and age, tumor diameter, tumor depth, invasion level, degree of differentiation, invasion pattern, TKGLY, PNI, LVI, presence of tumor at surgical margin and tumor stage, in TKGLY pattern; significance was observed in age, gender, invasion level, invasion pattern and tumor location. TT and TKGLY are newly introduced parameters to current practice. Both parameters are simple, inexpensive, can be used without the need for immunohistochemical examination, and are histological factors with high reproducibility. Both parameters can provide useful information in head and neck cSCC. TT correlates better with traditional prognostic factors than TKGLY and is more prominent for clinical use.