Prognostic and clinicopathological significance of tumor-stroma ratio in head and neck squamous cell carcinoma: A systematic review

Abstract

Background Analysis of the tumor microenvironment has been proposed as a strategy for the treatment and prognosis of different neoplastic processes. A grading system based on the tumor-stroma ratio (TSR), which evaluates the proportion of stroma in relation to neoplastic parenchyma at the invasion front, has shown a strong prognostic value in different neoplastic processes. The aim of the present systematic review was to understand the role of the TSR in head and neck squamous cell carcinoma (HNSCC), evaluating its correlation with clinical and prognostic parameters. Material and Methods An electronic search was performed in PubMed/Medline, Web of Science, Science Direct, Scopus, Embase, and the Cochrane Collaboration Library. Publications assessing the relationship between TSR and prognosis in cases of HNSCC were eligible. The quality of the studies was assessed independently by four evaluators using the Newcastle-Ottawa scale. Results After application of the previously es+lished inclusion/exclusion criteria, nine articles were included in the qualitative synthesis. With regards to quality on the Newcastle-Ottawa scale, an overall value of 4.55 was obtained. This systematic review demonstrated a strong association between TSR and prognosis in esophageal and oral squamous cell carcinomas. Conclusions Histopathological analysis of the TSR can optimize the analysis of the prognosis of cases diagnosed with HNSSC. In addition, the TSR is a reliable and simple parameter that can be evaluated in hematoxylin/eosin-stained slides during routine laboratory examinations, showing high inter- and intraobserver agreement. Key words: Head and neck cancer, squamous cell carcinoma, grade prognosis, tumor-stroma ratio.

Prognostic outcomes of oral squamous cell carcinoma derived from proliferative verrucous leukoplakia: A systematic review

“…Respectively, the gingiva, buccal mucosa, palate and tongue were the main sites of P‐OSCC emergence, in contrast to conventional OSCC, which are classically described as mainly affecting the tongue (Chi et al, 2015). This location information may be an impact factor in the prognosis of patients with P‐OSCC, since tumours of the gingiva, buccal mucosa and hard palate develop fewer metastases (de Araújo et al, 2008).…”

Malignant mesothelioma tumours: molecular pathogenesis, diagnosis, and therapies accompanying clinical studies

“…Asbestos fibers have been shown to phosphorylate and generate many pro-oncogenic protein kinases in mesothelial cells, in addition to interfering with mitosis ( 31 ). Malignant cells can utilize mesothelial cells to secrete platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and inflammatory tumor growth factor (ITGF) ( 32 ). The pathogenesis of mesothelioma is likely to include factors that are unique to the host as well as those that are universal.…”

Biomolecular alterations temporally anticipate microarchitectural modifications of collagen in oral tongue squamous cell carcinoma

“… 5 The stroma represents the main component of tumor microenvironment (TME) and plays a pivotal role in cancer progression and therapy resistance. 6 , 7 , 8 , 9 , 10 , 11 , 12 It consists of non-malignant tumor cells and ECM; however, although stroma cells are not malignant themselves, the tumor-stroma interaction allows the acquisition of an abnormal phenotype. 13 …”

“…The temporal relationship between biomolecular alteration and structural modification of tumor stroma is still largely unknown: stroma alterations seem to occur before tumor is clearly detectable and have been shown to significantly predict poor patient outcomes. 10 , 14 In particular, tumor stroma outgrowth is characterized by abnormal matrix secretion and collagen synthesis, attributable to hypoxia and chronic inflammation, leading to an edematous and unstable TME. 15 , 16 To date, OTSCC pathological staging is based on morphological features of tumor parenchyma analyzed by conventional histological techniques, overlooking the importance of tumor stroma from a prognostic and therapeutic standpoint.…”