High Density Tumor Budding Associated with Lymph Node Metastasis iin Penile Squamouse Cell Carcinoma

Introduction. Tumors of the penis are the rarest tumors of the genitourinary system, it represents 0.5% malignant tumors. The major risk factor was phimosis and human papillomavirus (HPV) infection.  Tumor budding is believed as one of prognostic factor in some cancer such as colorectal cancer and oral squamous cell carcinoma. However, tumor budding in penile squamous cell carcinoma had not been studied yet. For that reason, this study aim is to correlate high density tumor budding with lymph node metastasis in penile squamous cell carcinoma especially in Bali. Material &Methods. This was a cross-sectional study of 31 penile SCC patient. Clinicopathologic data included lymph node metastasis, histologic type, LVI, TIL, age, stage and grade.  Tumor budding is single tumor cells or small groups of 5 tumour cells at the invasive tumour front. All variables were analyzed by the Chi-square analysis with a significance value of p <0.05. Results high density of tumor budding were related with lymph node metastasis (2.03 – 15.82, 95%CI, p=0.001), grade tumor (2.89 – 286.43, 95%CI, p=0.001), stage (1.82 – 66.37, 95%CI, p=0.009), TIL (3.89 – 410.87, 95%CI, p=0.001 and LVI (5.58 - 659.28, 95%CI, p=0.001). On the other hand, tumor budding density were not significantly relate to age and histology type. Conclusion. Tumor budding is considered as a simple prognostic tools and inexpensive than other molecular and proteomic methods. The use of tumour budding as additional pathologic report and prognostic factor in penile SCC is therefore proposed.

Key words: tumour budding, penile squamous cell carcinoma