Tumour Budding Correlates with Aggressiveness of Cutaneous Squamous-cell Carcinoma

Background/Aim: Tumour budding (TB) is a specific pathological feature that has been found to be associated with an aggressive outcome in several cancer types; however, to our knowledge, TB has not yet been assessed in squamous-cell carcinomas of the skin (SCC). The aim of the study was to study whether TB correlates with aggressiveness in cutaneous SCC. Materials and Methods: We examined 31 aggressive SCC (that later developed local recurrences or metastases) in comparison with 21 nonaggressive SCC (not complicated by recurrence or metastasis). TB was expressed as the mean number of tumour buds in five adjacent high-power fields of each SCC. Results: Aggressive SCC had a much higher TB score compared to control SCC (1.63+/-1.35 vs. 0.49+/-0.9, p<0.001). Conclusion: As with other cancer types, TB seems to be a pathological marker of aggressiveness of cutaneous SCC, along with other features known to be associated with an aggressive outcome (tumour thickness, level of invasion and lymphovascular or perineural invasion). Further studies including a larger number of tumours will hopefully validate TB as a new pathological predictor of aggressiveness in cutaneous SCC and will allow its correlation with other pathological features of SCC aggressiveness to be defined.