Tsunade has her regeneration jutsu active and it doesn't run out of chakra.
Who KO's who first?
Hulk curbstomps her. She has him on speed and skill, but her strength is too far below him to KO him in time (if at all, which I don't think she can), that she stands much of a chance. I don't really think Tsunade could best even Namor, let alone Hulk.
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