Tumour Budding and Tumour Stroma Ratio are Reliable Predictors for Death and Recurrence in Elderly Stage I Colon Cancer Patients

Zengin, Mehmet

doi:10.1016/j.prp.2019.152635

Cited by 12 publications

(17 citation statements)

References 30 publications

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“…Also, it has been reported that the stroma of the tumour may affect the response to chemotherapy [39,40]. On the other hand, the increase in immature stroma has been associated with tumour budding, which is known as an indicator of epithelial-mesenchymal transition [24]. In this study, we found that the rate of stroma was significantly higher in tumours expressing CXCL12 and CXCR4.…”

Section: Discussionsupporting

confidence: 53%

“…Cases with more than 50 lymphocytes for LIR and cases with more than 50% stroma for TSR were considered positive [24]. Tumour budding was defined as the presence of small tumour cells in the invasive area of the tumour, and cases with more than 10 tumour buds were classified as positive [24]. Representative examples of research are shown in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of CXCL12 and CXCR4 to predict poor survival in lymph node-positive colorectal cancer patients

Zengin¹,

Dursun²,

Behzatoğlu³

et al. 2020

pjp

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It is well known that interactions in the tumour microenvironment are very important in the progression of tumours. We investigated the relationship between chemokine ligand type 12 (CXCL12), chemokine receptor type 4 (CXCR4) and survival in advanced colorectal cancers (CRC). Primary tumour samples of stage III-IV CRC patients were investigated for CXCL12 and CXCR4. Chemokine ligand type 12 and CXCR4 expressions were significantly associated with poor prognostic factors (e.g. for CXCL12: lymphatic invasion [p = 0.009], positive surgical margin [p = 0.006], advanced stage [p = 0.028], etc.). Also, these parameters were independent risk factors for low LIR (e.g. for CXCL12: Odds ratio [OR] = 2.27, p = 0.001) and low tumour stroma-ratio (TSR; e.g. for CXCL12: OR = 1.18, p = 0.003). In univariate analysis, 5-year RFS and OS were poor (e.g. for CXCL12: RFS, p < 0.001 and OS, p = 0.001). Multivariate analysis showed that these parameters were independent poor survival parameters for RFS and OS (e.g. for CXCL12: Hazard ratio [HR] = 3.54 [CI: 1.52-4.67], p = 0.001 and HR = 2.74 [1.48-4.71], p = 0.025). We showed that CXCL12 and CXCR4 expressions are poor prognostic factors in lymph node-positive CRC patients and are associated with low TSR and low LIR.

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Section: Discussionsupporting

confidence: 53%

Section: Methodsmentioning

confidence: 99%

Evaluation of CXCL12 and CXCR4 to predict poor survival in lymph node-positive colorectal cancer patients

Zengin¹,

Dursun²,

Behzatoğlu³

et al. 2020

pjp

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“…26 Since its first report in colorectal cancer patients in 2007, measurement of the TSR on H&E-stained slides has demonstrated its robustness and high reproducibility in other solid epithelial tumours. [31][32][33][34] In particular, almost all of the studies have shown that a low TSR (i.e. the presence of a high proportion of stroma in tumour tissue) is significantly related to poor prognosis in patients with different types of solid tumour.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, measurement of the TSR seems to be a reliable, accurate and economical method with which to characterise the role of tumour stroma in tumour progression 26 . Since its first report in colorectal cancer patients in 2007, measurement of the TSR on H&E‐stained slides has demonstrated its robustness and high reproducibility in other solid epithelial tumours 31–34 . In particular, almost all of the studies have shown that a low TSR (i.e.…”

Section: Discussionmentioning

confidence: 99%

Addition of the tumour–stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma

et al. 2020

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Aims One of the objectives of current research is to customise the treatment of cancer patients. The achievement of this objective requires stratification of patients based on the most significant prognostic factors. The aims of this study were to evaluate the prognostic value of the tumour–stroma ratio (TSR), defined as the proportion of tumour cells relative to surrounding stroma, in patients with oral tongue squamous cell carcinoma (OTSCC), and to develop a prognostic nomogram based on the most significant clinicopathological features. Methods and results Clinicopathological data of 211 patients treated at ‘Ospedali Riuniti’ General Hospital (Ancona, Italy) for OTSCC were collected. One hundred and thirty‐nine patients were restaged according to the 8th edition American Joint Committee on Cancer (AJCC) staging system. Evaluation of the TSR was performed on haematoxylin and eosin‐stained slides, and correlation with survival outcomes was evaluated. In addition, with the aim of integrating the independent value of the TSR with the 8th edition AJCC staging system, a prognostic nomogram for OTSCC has been developed. OTSCC with a low TSR (i.e. a high proportion of stroma and a low proportion of tumour cells) was shown to have negative prognostic value in terms of disease‐specific survival, with a hazard ratio (HR) of 1.883 and a 95% confidence interval (CI) of 1.033–3.432 (P = 0.039), and overall survival (HR = 1.747, 95% CI 0.967–3.154; P = 0.044), independently of other histological and clinical parameters. For the cohort of 139 patients restaged according to the 8th edition AJCC staging system, variables correlating with a poor prognosis were: the TSR, perineural invasion, and sex. The nomogram built on these parameters showed good predictive capacity, outperforming the 8th edition AJCC staging system in stratifying disease‐specific survival in OTSCC patients. Conclusions Including the TSR in the predictive model could improve risk stratification of OTSCC patients and aid in making treatment decisions.

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“…Several studies indicated that tumor stroma overgrowth could predict poor survival outcomes. These results were, however, contradicted by some scholars (12)(13)(14)(15). Considering the need for new prognostic factors to better determine therapeutic strategies, we performed a meta-analysis to analyze TSR prognostic value in RC patients.…”

Section: Introductionmentioning

confidence: 88%

Prognostic Value of Tumor-Stroma Ratio in Rectal Cancer: A Systematic Review and Meta-analysis

et al. 2021

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BackgroundTumor-stroma ratio (TSR) is a promising new prognostic predictor for patients with rectal cancer (RC). Although several studies focused on this pathologic feature, results from those studies were still inconsistent.MethodsThis research aimed to estimate the prognostic values of TSR for RC. A search of PubMed, EMBASE, and Web of Science was carried out. A meta-analysis was performed on disease-free survival, cancer-specific survival, and overall survival in patients with RC.ResultsThe literature search generated 1,072 possible studies, of which a total of 15 studies, involving a total of 5,408 patients, were eventually included in the meta-analysis. Thirteen of the 15 articles set the cutoff for the ratio of stroma at 50%, dividing patients into low-stroma and high-stroma groups. Low TSR (rich-stroma) was significantly associated with poorer survival outcome. (DFS: HR 1.54, 95% CI 1.32–1.79; OS: HR 1.52 95% CI 1.34–1.73; CSS: HR 2.05 95% CI 1.52–2.77).ConclusionPresent data support TSR to be a risk predictor for poor prognosis in RC patients.

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Tumour Budding and Tumour Stroma Ratio are Reliable Predictors for Death and Recurrence in Elderly Stage I Colon Cancer Patients

Cited by 12 publications

References 30 publications

Evaluation of CXCL12 and CXCR4 to predict poor survival in lymph node-positive colorectal cancer patients

Evaluation of CXCL12 and CXCR4 to predict poor survival in lymph node-positive colorectal cancer patients

Addition of the tumour–stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma

Prognostic Value of Tumor-Stroma Ratio in Rectal Cancer: A Systematic Review and Meta-analysis

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