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Meta-Analysis
. 2018 Feb 20;118(4):577-586.
doi: 10.1038/bjc.2017.425. Epub 2017 Nov 30.

Tumour budding in oral squamous cell carcinoma: a meta-analysis

Alhadi Almangush  1   2   3 , Matti Pirinen  4   5   6 , Ilkka Heikkinen  1   2 , Antti A Mäkitie  7 , Tuula Salo  2   8   9   10 , Ilmo Leivo  11
Affiliations
Meta-Analysis

Tumour budding in oral squamous cell carcinoma: a meta-analysis

Alhadi Almangush et al. Br J Cancer. .

Abstract

Background: Tumour budding has been reported as a promising prognostic marker in many cancers. This meta-analysis assessed the prognostic value of tumour budding in oral squamous cell carcinoma (OSCC).

Methods: We searched OvidMedline, PubMed, Scopus and Web of Science for articles that studied tumour budding in OSCC. We used reporting recommendations for tumour marker (REMARK) criteria to evaluate the quality of studies eligible for meta-analysis.

Results: A total of 16 studies evaluated the prognostic value of tumour budding in OSCC. The meta-analysis showed that tumour budding was significantly associated with lymph node metastasis (odds ratio=7.08, 95% CI=1.75-28.73), disease-free survival (hazard ratio=1.83, 95% CI=1.34-2.50) and overall survival (hazard ratio=1.88, 95% CI=1.25-2.82).

Conclusions: Tumour budding is a simple and reliable prognostic marker for OSCC. Evaluation of tumour budding could facilitate personalised management of OSCC.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Tumour budding, defined as single cancer cell or clusters of less than five cells at the invasive front of oral squamous cell carcinoma (OSCC). (A) Low magnification (× 4); and (B) high magnification (× 20) of the area inside the circle.
Figure 2
Figure 2
Flow diagram outlining the search strategy and the search results along various steps.
Figure 3
Figure 3
Forest plots for the pooled analyses of the studies evaluated the prognostic value of tumour budding in assessing lymph node metastasis of OSCC. (A) All eligible studies. (B) Studies used five-bud cutoff point. (C) Studies used 10-bud cutoff point.
Figure 4
Figure 4
Pooled analysis for disease-free survival.
Figure 5
Figure 5
Pooled analyses for overall survival. (A) All stages of OSCC. (B) Pooled analysis for overall survival of OSCC including studies of early stage only. (C) Pooled analysis for overall survival including only oral tongue cancer studies which used five-bud cutoff point. (D) Pooled analysis for overall survival including early stage oral tongue cancer studies that used five-bud cutoff point.
See this image and copyright information in PMC

References

    1. Almangush A, Bello IO, Coletta RD, Makitie AA, Makinen LK, Kauppila JH, Pukkila M, Hagstrom J, Laranne J, Soini Y, Kosma VM, Koivunen P, Kelner N, Kowalski LP, Grenman R, Leivo I, Laara E, Salo T (2015. a) For early-stage oral tongue cancer, depth of invasion and worst pattern of invasion are the strongest pathological predictors for locoregional recurrence and mortality. Virchows Arch 467(1): 39–46. - PubMed
    1. Almangush A, Bello IO, Keski-Santti H, Makinen LK, Kauppila JH, Pukkila M, Hagstrom J, Laranne J, Tommola S, Nieminen O, Soini Y, Kosma VM, Koivunen P, Grenman R, Leivo I, Salo T (2014) Depth of invasion, tumor budding, and worst pattern of invasion: prognostic indicators in early-stage oral tongue cancer. Head Neck 36(6): 811–818. - PMC - PubMed
    1. Almangush A, Coletta RD, Bello IO, Bitu C, Keski-Santti H, Makinen LK, Kauppila JH, Pukkila M, Hagstrom J, Laranne J, Tommola S, Soini Y, Kosma VM, Koivunen P, Kowalski LP, Nieminen P, Grenman R, Leivo I, Salo T (2015. b) A simple novel prognostic model for early stage oral tongue cancer. Int J Oral Maxillofac Surg 44(2): 143–150. - PubMed
    1. Almangush A, Heikkinen I, Makitie AA, Coletta RD, Laara E, Leivo I, Salo T (2017. a) Prognostic biomarkers for oral tongue squamous cell carcinoma: a systematic review and meta-analysis. Br J Cancer 117(6): 856–866. - PMC - PubMed
    1. Almangush A, Karhunen M, Hautaniemi S, Salo T, Leivo I (2016) Prognostic value of tumour budding in oesophageal cancer: a meta-analysis. Histopathology 68(2): 173–182. - PubMed

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