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. 2024 Apr 18;14(8):836.
doi: 10.3390/diagnostics14080836.

Unselective Measurement of Tumor-to-Stroma Proportion in Colon Cancer at the Invasion Front-An Elusive Prognostic Factor: Original Patient Data and Review of the Literature

Zsolt Fekete  1   2 , Patricia Ignat  1   2 , Amelia Cristina Resiga  3 , Nicolae Todor  2 , Alina-Simona Muntean  2 , Liliana Resiga  2 , Sebastian Curcean  1   2 , Gabriel Lazar  1 , Alexandra Gherman  1   2 , Dan Eniu  1   3
Affiliations

Unselective Measurement of Tumor-to-Stroma Proportion in Colon Cancer at the Invasion Front-An Elusive Prognostic Factor: Original Patient Data and Review of the Literature

Zsolt Fekete et al. Diagnostics (Basel). .

Abstract

The tumor-to-stroma ratio is a highly debated prognostic factor in the management of several solid tumors and there is no universal agreement on its practicality. In our study, we proposed confirming or dismissing the hypothesis that a simple measurement of stroma quantity is an easy-to-use and strong prognostic tool. We have included 74 consecutive patients with colorectal cancer who underwent primary curative abdominal surgery. The tumors have been grouped into stroma-poor (stroma < 10%), medium-stroma (between 10 and 50%) and stroma-rich (over 50%). The proportion of tumor stroma ranged from 5% to 70% with a median of 25%. Very few, only 6.8% of patients, had stroma-rich tumors, 4% had stroma-poor tumors and 89.2% had tumors with a medium quantity of stroma. The proportion of stroma, at any cut-off, had no statistically significant influence on the disease-specific survival. This can be explained by the low proportion of stroma-rich tumors in our patient group and the inverse correlation between stroma proportion and tumor grade. The real-life proportion of stroma-rich tumors and the complex nature of the stroma-tumor interaction has to be further elucidated.

Keywords: adjuvant treatment; colon cancer; fibrosis; pathology markers; stroma-to-tumor ratio; tumor stroma.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Example of a stroma-poor tumor, eosin–hematoxylin (EH) stain, magnification 200×, stroma around 5%.
Figure 2
Figure 2
Example of a tumor with medium-content stroma, eosin–hematoxylin (EH) stain, magnification 200×, stroma around 40%.
Figure 3
Figure 3
Example of a stroma-rich tumor, eosin–hematoxylin (EH) stain, magnification 200×, stroma around 70%.
Figure 4
Figure 4
Disease-specific survival for different stages.
Figure 5
Figure 5
p-value for different cut-off values of stroma proportion.
Figure 6
Figure 6
Disease-specific survival for patients with a stroma proportion less than 25% and more than 25%.
Figure 7
Figure 7
Disease-specific survival for patients with G1, G2 and G3 tumors.
Figure 8
Figure 8
Individual patient data on the percentage of stroma for patients with G1, G2 and G3 tumors.
See this image and copyright information in PMC

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