The proportion of tumor-stroma as a strong prognosticator for stage II and III colon cancer patients: validation in the VICTOR trial

Abstract

This study confirms the intra-tumor stroma ratio as a prognostic factor. This parameter could be a valuable and low cost addition to the TNM status and next to current high-risk parameters such as microsatellite instability status used in routine pathology reporting. When adding the stroma-parameter to the ASCO criteria, the rate of 'undertreated' patients dropped from 5.9% to 4.3%, the 'overtreated' increased with 6.8% but the correctly classified increased with an additional 14%.

Tumor–stroma ratio predicts recurrence in patients with colon cancer treated with neoadjuvant chemotherapy

“…These observations corroborate previous findings [4,[6][7][8]10], and thus persist after neoadjuvant chemotherapy.…”

“…A low TSR in the surgically resected primary tumors was detected in 47% of the patients, a ratio comparable to the latest studies in the literature [4,5] although the initial studies generally indicated a lower frequency (24-29%) of 'low TSR' [6][7][8][9][10]. A possible influence of neoadjuvant chemotherapy on tumor tissue composition may explain, at least partly, this difference.…”

“…Most studies regarding the technical aspects of TSR scoring provide kappa-values pointing to at least moderate, but mostly substantial and even optimal reproducibility. The current literature unanimously points toward TSR as a prognostic marker in patients operated for colon cancer [4][5][6][7][8][9][10], although results from larger population based cohorts are still awaited. A high amount of stroma (low TSR) is related to a poor prognosis and may also influence the delivery of chemotherapeutics to the cancer cells.…”

MicroRNA Classifier and Nomogram for Metastasis Prediction in Colon Cancer

“…Moreover, it is crucial to subsequently validate the model in an independent patient cohort. Exclusion of patients with low percentages of cancerous epithelial cells leads to biased patient cohorts, as high stroma content of tumors is itself associated with worse clinical outcome (36). Inclusion of these patients requires selection of target cells by microdissection (18), due to the tissuetype and cell-specific nature of miRNA expression (16,17).…”

A Monotonic and Prognostic Genomic Signature from Fibroblasts for Colorectal Cancer Initiation, Progression, and Metastasis

“…As an example, SERPINE1, POSTN, HBEGF, PTX3 or TGFb2, IL1b, and TGFb1 responsive genes, increase from NCF to CAF-LM, with IL1b and TGFb1 being the main inductors of fibroblast activation. This transcriptomic program for wound response seems to be more effective in the more aggressive liver and primary tumors, and could explain the greater degree of desmoplasia that is associated with poor outcome (37). About downregulated genes, there is an enrichment of genes involved in inflammatory processes.…”