Tumor budding is a prognostic factor in head and neck squamous cell carcinoma: A comprehensive meta-analysis and trial sequential analysis.

Mortality is linked to tumor budding (TB) in certain neoplasms. TB as a relevant histopathological feature is conditioned by tumor site, a specific study on head and neck squamous cell carcinoma (HNSCC) is needed. A comprehensive meta-analysis was undertaken to investigate the relationship between TB and HNSCC-related outcomes. Overall 42 studies were included. Patients harboring high TB reported an Overall Survival (OS) Hazard Ratio (HR) of 2.63 (95% confidential interval (CI) 2.04–3.39; p-value < 0.001), Disease-free Survival (DFS) HR of 1.88 (95%CI 1.57–2.24; p-value <0.001) and Disease-specific Survival (DSS) HR of 2.14 (95%CI 1.81–2.52; p-value <0.001). Lymph Node Metastasis (LNM) studies harbored null heterogeneity and marked association with TB (Odds Ratio (OR) = 4.48, 95%CI 2.97–6.76; p-value < 0.001). Trial Sequential Analysis (TSA) supported definitive results for DSS. The study has provided compelling evidence that there is a significant association between TB and a worse prognosis for HNSCC. [Display omitted] • Tumor budding (TB) is characterized by isolated cells or clusters of tumor cells in the stroma of the invasive front of cancer. • This condition is a relevant histopathological feature that is conditioned by the tumor site. • Mortality is linked to TB in certain neoplasms. • A meta-analysis investigated the relationship between TB and head and neck squamous cell carcinoma (HNSCC) related outcomes. • The results provided a compelling association between TB and a worse prognosis in HNSCC patients. [ABSTRACT FROM AUTHOR]