High tumor budding in head and neck squamous cell carcinoma (HNSCC) is a critical prognostic factor, showing a five-year overall survival rate of only 26% compared to 85% for low tumor budding cases. This study involving 98 patients found that high tumor budding was associated with increased metastasis to neck lymph nodes and worse overall survival outcomes. The presence of more than four tumor buds also correlated with aggressive tumor features like lymphovascular invasion and extranodal extension. Researchers identified a threshold of 4.5 buds for predicting survival and recommended integrating tumor budding assessment into treatment planning. Further studies are needed to validate these findings.

Source: Journal of Clinical Medicine