European Journal of Molecular & Clinical Medicine ISSN 2515-8260 Volume 06, Issue 01, 2019 81 Prognostic value of tumor budding in oral squamous cell carcinoma Dr. Sandhya Sundar 1 , Dr. Pratibha Ramani 1 , Dr. Gheena S 1 , Dr.Abilasha R 1 , 1 Saveetha Dental College & Hospitals, Saveetha Institute of medical and technical sciences Dr. Sandhya Sundar 9 cholapuram Street, thiruvanmiyur, Chennai- 600041 Phone number - 8754499587, 044-24450224 Mail:sandhyas.sdc@saveetha.com ABSTRACT Tumor budding is the histological phenomenon seen as a detached, discohesive small cluster of cells in the invasive tumor front. Tumor buds may provide a histological means for the assessment of epithelial-mesenchymal interaction and facilitate early prediction of prognosis.The present study aims to assess the prognostic significance of the tumor budding in oral squamous cell carcinoma(OSCC). Detailed Histopathological scoring of the oral squamous cell carcinoma tissue and lymph nodes including the evaluation of tumor budding was performed by two individual observers retrospectively. The association between various clinicopathological parameters and the budding index was analyzed using chi-square test and fisher’s exact tests. Tumor budding was demonstrated in the invasive tumor front of all OSCC cases. High-intensity tumor budding was seen in stage 4 cancers with tumor size of > 4cms. Histologically, they were related to deep and extensive tumors, having an invasive front with infiltrative cells in groups or cords, dense stromal type in association with mild inflammation invariably. All of the cases with lymph node metastases were tumor budding positive. Thus this study emphasizes the importance of tumor budding evaluation in regular pathology practice in the management of OSCC cases. Key Words Prognosis, Oral Squamous Cell Carcinoma, Tumor budding, Histological evaluation Introduction Two-thirds of cancers occurring in India are Oral Cancers. Oral cancer commonly oral squamous cell carcinoma remains to have a poor five-year survival rate due to its early tendency to metastasize lymph nodes and frequent recurrences. Early prediction of oral cancer prognosis can help deliver appropriate treatment that does not underestimate the disease process. The most progressed layers of tumor reside in the invasive tumor front, which forms the advancing edge of the cancer and gives excellent details of prognosis. “ Tumor budding” is the histological phenomenon seen as a detached single or cluster of tumor cells in the invasive tumor front(1). These cells undergoing epithelial-mesenchymal transition has been well associated with high tumor grade, deep invasion, nodal metastasis, increased risk of recurrence and poor