Combined Model of Tumor–Stroma Ratio and Tumor Budding Are Not Associated with Tumor Recurrence or Metastasis in Oral Squamous Cell Carcinoma Patients

Histopathological grading of oral squamous cell carcinoma is currently based on differentiation of cells, while additional histological parameters, such as the tumor–stroma ratio (TSR), tumor budding (TB), or the combined TSR/tumor budding model could better assess tumor biological behavior and moni...

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Main Authors: Drago Boščić, Emili Dragaš, Andro Košec, Goran Geber, Čedna Tomasović-Lončarić, Davor Vagić
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/15/1844
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author Drago Boščić
Emili Dragaš
Andro Košec
Goran Geber
Čedna Tomasović-Lončarić
Davor Vagić
author_facet Drago Boščić
Emili Dragaš
Andro Košec
Goran Geber
Čedna Tomasović-Lončarić
Davor Vagić
author_sort Drago Boščić
collection DOAJ
description Histopathological grading of oral squamous cell carcinoma is currently based on differentiation of cells, while additional histological parameters, such as the tumor–stroma ratio (TSR), tumor budding (TB), or the combined TSR/tumor budding model could better assess tumor biological behavior and monitoring of patients. <b>Background/Objectives</b>: To integrate risk factors associated with tumor progression: the TSR, TB and TSR/tumor budding model, whose prognostic significance in oral cancer has not yet been evaluated. <b>Methods</b>: An observational cohort retrospective study assembled according to STROBE guidelines on histological materials from 196 patients with invasive squamous cell carcinoma of the oral cavity. The goal of the analysis was to evaluate the association between the tumor stroma ratio, tumor budding, and the combined model of TSR/TB with the clinical and pathologic features of patients with squamous cell carcinoma of the oral cavity and to determine the prognostic value of this model in relation to disease-free survival (DFS) <b>Results</b>: The analysis did not show that the tumor stroma ratio (TSR), tumor budding, and the combined model of TSR/tumor budding were statistically significantly associated with the occurrence of metastatic disease at the start of treatment or during postoperative follow-up, but confirmed the value of depth-of-invasion (DOI) as a negative prognostic factor (HR 15.3, <i>p</i> < 0.001). <b>Conclusions</b>: The TSR, TB, and the combined TSR/TB model were not found to be statistically significant predictors for the disease progression in the Cox regression survival analysis but were found to have a significant correlation with known negative prognostic factors: DOI, neural invasion, and T category.
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spelling doaj-art-e964b140aba94221bc9c8542b2bcfb7e2025-08-20T03:35:58ZengMDPI AGDiagnostics2075-44182025-07-011515184410.3390/diagnostics15151844Combined Model of Tumor–Stroma Ratio and Tumor Budding Are Not Associated with Tumor Recurrence or Metastasis in Oral Squamous Cell Carcinoma PatientsDrago Boščić0Emili Dragaš1Andro Košec2Goran Geber3Čedna Tomasović-Lončarić4Davor Vagić5Department of Otorhinolaryngology, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaSchool of Medicine, University of Zagreb, 10000 Zagreb, CroatiaSchool of Medicine, University of Zagreb, 10000 Zagreb, CroatiaDepartment of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre Milosrdnice, Vinogradska Cesta 29, 10000 Zagreb, CroatiaDepartment of Pathology, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaSchool of Medicine, University of Zagreb, 10000 Zagreb, CroatiaHistopathological grading of oral squamous cell carcinoma is currently based on differentiation of cells, while additional histological parameters, such as the tumor–stroma ratio (TSR), tumor budding (TB), or the combined TSR/tumor budding model could better assess tumor biological behavior and monitoring of patients. <b>Background/Objectives</b>: To integrate risk factors associated with tumor progression: the TSR, TB and TSR/tumor budding model, whose prognostic significance in oral cancer has not yet been evaluated. <b>Methods</b>: An observational cohort retrospective study assembled according to STROBE guidelines on histological materials from 196 patients with invasive squamous cell carcinoma of the oral cavity. The goal of the analysis was to evaluate the association between the tumor stroma ratio, tumor budding, and the combined model of TSR/TB with the clinical and pathologic features of patients with squamous cell carcinoma of the oral cavity and to determine the prognostic value of this model in relation to disease-free survival (DFS) <b>Results</b>: The analysis did not show that the tumor stroma ratio (TSR), tumor budding, and the combined model of TSR/tumor budding were statistically significantly associated with the occurrence of metastatic disease at the start of treatment or during postoperative follow-up, but confirmed the value of depth-of-invasion (DOI) as a negative prognostic factor (HR 15.3, <i>p</i> < 0.001). <b>Conclusions</b>: The TSR, TB, and the combined TSR/TB model were not found to be statistically significant predictors for the disease progression in the Cox regression survival analysis but were found to have a significant correlation with known negative prognostic factors: DOI, neural invasion, and T category.https://www.mdpi.com/2075-4418/15/15/1844oral squamous cell carcinomatumor buddinghistopathologyprognosistumor–stroma ratio
spellingShingle Drago Boščić
Emili Dragaš
Andro Košec
Goran Geber
Čedna Tomasović-Lončarić
Davor Vagić
Combined Model of Tumor–Stroma Ratio and Tumor Budding Are Not Associated with Tumor Recurrence or Metastasis in Oral Squamous Cell Carcinoma Patients
Diagnostics
oral squamous cell carcinoma
tumor budding
histopathology
prognosis
tumor–stroma ratio
title Combined Model of Tumor–Stroma Ratio and Tumor Budding Are Not Associated with Tumor Recurrence or Metastasis in Oral Squamous Cell Carcinoma Patients
title_full Combined Model of Tumor–Stroma Ratio and Tumor Budding Are Not Associated with Tumor Recurrence or Metastasis in Oral Squamous Cell Carcinoma Patients
title_fullStr Combined Model of Tumor–Stroma Ratio and Tumor Budding Are Not Associated with Tumor Recurrence or Metastasis in Oral Squamous Cell Carcinoma Patients
title_full_unstemmed Combined Model of Tumor–Stroma Ratio and Tumor Budding Are Not Associated with Tumor Recurrence or Metastasis in Oral Squamous Cell Carcinoma Patients
title_short Combined Model of Tumor–Stroma Ratio and Tumor Budding Are Not Associated with Tumor Recurrence or Metastasis in Oral Squamous Cell Carcinoma Patients
title_sort combined model of tumor stroma ratio and tumor budding are not associated with tumor recurrence or metastasis in oral squamous cell carcinoma patients
topic oral squamous cell carcinoma
tumor budding
histopathology
prognosis
tumor–stroma ratio
url https://www.mdpi.com/2075-4418/15/15/1844
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