ArticleGut2004
Histological categorisation of fibrotic cancer stroma in advanced rectal cancer.
Article in Gut, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers.
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Who cites it
96 citing papers in PubMed, 195 citations in OpenAlex.
- Prognostic value of desmoplastic reaction characterisation in stage II colon cancer: prospective validation in a Phase 3 study (SACURA Trial).British journal of cancer · 2021Trial
- Stromal organization as predictive biomarker for the treatment of colon cancer with adjuvant bevacizumab; a post-hoc analysis of the AVANT trial.Cellular oncology (Dordrecht, Netherlands) · 2019Trial
- Study protocol of the SACURA trial: a randomized phase III trial of efficacy and safety of UFT as adjuvant chemotherapy for stage II colon cancer.BMC cancer · 2012Trial
- Desmoplastic reaction at the invasive front of upper urinary tract urothelial carcinoma: prognostic impact and associations with tumour invasiveness and immune-inflammatory status.Virchows Archiv : an international journal of pathology · 2026Article
- Cancer-associated fibroblasts in thyroid cancer stroma correlate with tumour progression and desmoplasia: a histopathological study.Thyroid research · 2026Article
- Analysis of the relationship between immunological microenvironment and prognosis in pancreatic cancer.American journal of cancer research · 2026Article
- The prognostic value of tumor macroscopic morphology in colorectal cancer.Translational oncology · 2026Article
- Tumour tissue: heterogeneous, but not disordered.Nature reviews. Cancer · 2025Article
- Article
- A prognostic nomogram based on desmoplastic reaction/tumor deposit modified lymph node staging in colorectal cancer.Journal of gastrointestinal oncology · 2025Article
- Prognostic impact of tumor‑associated stroma in triple-negative breast cancer.Breast cancer (Tokyo, Japan) · 2025Article
- The impact of preoperative treatments on the immune environment of rectal cancer.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2024Article
- Exploring prognostic biomarkers in pathological images of colorectal cancer patients via deep learning.The journal of pathology. Clinical research · 2024Article
- Serous Ovarian Carcinoma: Detailed Analysis of Clinico-Pathological Characteristics as Prognostic Factors.Cancers · 2024Article
- Tumour-stroma ratio (TSR) in breast cancer: comparison of scoring core biopsies versus resection specimens.Virchows Archiv : an international journal of pathology · 2024Article
- Biophysical perspectives to understanding cancer-associated fibroblasts.APL bioengineering · 2024Review
- Histologic, immunohistochemical, and in situ hybridization study of myxoid stroma in feline oral squamous cell carcinoma.The Journal of veterinary medical science · 2024Article
- Diagnostic and prognostic significance of keloid-like collagen remodeling patterns in the extracellular matrix of colorectal cancer.Pathology oncology research : POR · 2024Article
- Postoperative Prognosis According to Pathologic Categorization of Desmoplastic Reaction in Patients with Extrahepatic Cholangiocarcinoma.Annals of surgical oncology · 2023Article
- Relationships between physical and immunological tumor microenvironment in pancreatic ductal adenocarcinoma.Cancer science · 2023Article
36 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsBased on conflicting reports regarding the role of the fibrotic stromal response in cancer development--namely, that a desmoplastic reaction can favour either the host or the tumour--it is clear that the role of the stromal response is varied. We have classified the fibrotic stroma of rectal adenocarcinoma penetrating the muscularis propria, based on histologically identified stromal components.
methodsThree categories of stroma were used: mature-when the stroma was composed of mature collagen fibres (fine and elongated fibres into multiple layers); intermediate-when keloid-like collagen was intermingled with mature fibres; and immature-consisting of a myxoid stroma in which no mature fibres were included.
resultsIn a data set of 862 patients, 53% of patients had mature fibrotic cancer stroma, 33% had intermediate stroma, and 15% had immature stroma. Five year survival rates decreased as follows: mature stroma (80%), intermediate stroma (55%), and immature stroma (27%). The adverse tumour phenotype, tumour cell budding (conspicuous isolated cells or small clusters of cancer cells), was observed in the cancer fronts in tumours with unfavourable fibrotic stroma (p<0.0001). Based on multivariate analysis, categorised fibrotic stroma was selected as an independent prognostic parameter (hazard ratio 1.39; 95% confidence interval 1.17-1.64) together with tumour differentiation. By immunohistochemical examination, as maturation of the fibrotic stroma decreased, stromal T cells became significantly sparser. Furthermore, myofibroblasts were distributed extensively in immature fibrotic stroma compared with mature and intermediate fibrotic stroma.
conclusionThe morphological categorisation of fibrotic cancer stroma highlights the role of the stromal response in relation to the behaviour and host immune reactions of rectal adenocarcinoma and would be a useful tool for predicting patient prognostic outcome.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.