Research Article Volume 17 Issue 3 - July 2021 DOI: 10.19080/ARGH.2021.17.555962 Adv Res Gastroentero Hepatol Copyright © All rights are reserved by Zainab Waseem Tumor Budding in Esophageal Squamous Cell Carcinomas: Correlation with Prognosis and Grade of Tumor Zainab Waseem , Sajid Mushtaq, Mudassar Hussain, Usman Hassan and Maryam Hameed 1 Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan Submission: June 18, 2021; Published: July 09, 2021 *Corresponding author: Zainab Waseem, Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan Adv Res Gastroentero Hepatol 17(3): ARGH.MS.ID.555962 (2021) 001 Abstract Introduction: Tumor Budding has emerged as a promising indicator of prognosis in various carcinomas of the body. Since it is a H&E feature, its evaluation can and should be included in pathology reports wherever feasible. Aims: The aim of this study is to analyze the correlation of tumor budding with various prognostic factors of esophageal squamous cell carcinomas. Method and Results: Sixty-one cases of esophageal resections reported as squamous cell carcinoma at Shaukat Khanum Memorial Cancer Hospital and Research Centre between 2018 and 2019 were reviewed for tumor budding. Budding was classified into high (10 or more buds), intermediate (5 to 9 buds) and low (4 and less) bud groups. Each group was then correlated with lympho-vascular invasion, pN, pT stages, grade of the tumor and 1-year survival. P values were obtained from chi square tests (significant if less than 0.05) and showed statistical significance of tumor budding with tumor grade (p= 0.02), lympho-vascular invasion (p= 0.0004) and pN stage (p= 0.03). Survival graphs were plotted using Kaplan Meier plot in SPSS software. Conclusion: A higher bud group is a promising predictor of poor prognosis in esophageal squamous cell carcinomas and can assist in the planning of treatment in the patients. Keywords: Esophageal; Squamous Cell Carcinoma; Tumor Budding; Prognosis Introduction Squamous cell carcinoma constitutes 90% of all the tumors in esophagus. It is the sixth most common cancer diagnosed and treated at Shaukat Khanum Hospital, Lahore, Pakistan. The current practice of estimating prognosis in these patients utilizes the grade and stage of tumor as determined by the AJCC TNM system, however, the search for better and more reliable prognostic markers continue. Tumor budding is one of the emerging and promising prognostic markers which is currently being studied in several carcinomas. A higher bud group has been reported to confer an adverse prognosis. In this study, we aim to correlate tumor budding with pT, pN, lympho-vascular invasion, grade of tumor and prognosis in patients diagnosed with esophageal squamous cell carcinoma at Shaukat Khanum Hospital, Lahore. Materials and Methods Ethical issues The Institutional Review Board Approval was taken (IRB# EX- 28-05-20-02). Case selection Sixty-one esophageal resections grossed at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan from January 2018 to December 2019 were included in the study. These excluded cases of review originally grossed outside the hospital, and cases with suboptimal fixation. The blocks were fixed in 10% buffered formalin and embedded in paraffin. The tissues were then sectioned at 0.5um thickness and stained with