ArticleBritish journal of cancer2018
Predictive potential of tumour-stroma ratio on benefit from adjuvant bevacizumab in high-risk stage II and stage III colon cancer.
Article in British journal of cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- A scoping review of TSR analysis in colorectal cancer: implications for automated solutions.Oncology reviews · 2025Pooled it
- Impact of Tumor-Stroma Ratio on the Prognosis of Colorectal Cancer: A Systematic Review.Frontiers in oncology · 2021Pooled it
- Prognostic Value of Tumor-Stroma Ratio in Rectal Cancer: A Systematic Review and Meta-analysis.Frontiers in oncology · 2021Pooled it
- 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
- Tumour-Stroma Ratio as a Predictive Biomarker for Neoadjuvant Therapy Efficacy in Rectal Cancer.Cancers · 2026Review
- Contrast-enhanced CT-derived extracellular volume fraction in preoperative prediction of tumor-stroma ratio in colorectal cancer.Abdominal radiology (New York) · 2026Article
- Disease-Free Survival of Patients with Stage II Stroma-Rich Colorectal Adenocarcinomas with Microsatellite Stability.International journal of molecular sciences · 2025Article
- The tumour-stroma ratio as predictive aid towards a biopsy-based treatment strategy in rectal carcinoma.Histopathology · 2025Article
- Quantitative and qualitative metrics of tumor stroma in predicting ovarian cancer outcomes and expansion of its study with AI-based tools.Molecular therapy. Oncology · 2025Review
- Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients.Oncology letters · 2025Article
- Self-supervised learning reveals clinically relevant histomorphological patterns for therapeutic strategies in colon cancer.Nature communications · 2025Article
- Mean Apparent Propagator MRI: Quantitative Assessment of Tumor-Stroma Ratio in Invasive Ductal Breast Carcinoma.Radiology. Imaging cancer · 2024Article
- Results from the UNITED study: a multicenter study validating the prognostic effect of the tumor-stroma ratio in colon cancer.ESMO open · 2024Article
- Self-Supervised Learning Reveals Clinically Relevant Histomorphological Patterns for Therapeutic Strategies in Colon Cancer.bioRxiv : the preprint server for biology · 2024Article
- The Prognostic Impact of Tumor Border Configuration, Tumor Budding and Tumor Stroma Ratio in Colorectal Carcinoma.Turk patoloji dergisi · 2023Article
- Characteristics of tumour stroma in regional lymph node metastases in colorectal cancer patients: a theoretical framework for future diagnostic imaging with FAPI PET/CT.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2022Article
- Tumor budding and fibrotic focus-proposed grading system for tumor budding in invasive carcinoma no special type of the breast.Virchows Archiv : an international journal of pathology · 2022Article
- Serum-based measurements of stromal activation through ADAM12 associate with poor prognosis in colorectal cancer.BMC cancer · 2022Article
- The value of the tumour-stroma ratio for predicting neoadjuvant chemoradiotherapy response in locally advanced rectal cancer: a case control study.BMC cancer · 2021Article
- The prognostic value of tumor-stromal ratio combined with TNM staging system in esophagus squamous cell carcinoma.Journal of Cancer · 2021Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe tumour-stroma ratio (TSR) has proven to be an independent prognostic factor in colon cancer.
methodsHaematoxylin eosin tissue slides of patients from the AVANT trial were microscopically scored for TSR and categorised as stroma -low or stroma -high. Scores were correlated to the primary and secondary endpoint disease-free survival (DFS) and overall survival (OS).
resultsPatients with stroma-high tumours (N = 339, 28%) had a significantly shorter DFS (p < 0.001) compared to stroma-low tumours (N = 824, 68%). In the bevacizumab-FOLFOX-4 arm, DFS was significantly shorter compared to FOLFOX-4 in stroma-low tumours, with a hazard ratio (HR) of 1.94 (95% CI 1.24-3.04; p = 0.004). In stroma-high tumours a trend for better DFS was seen in bevacizumab-FOLFOX-4 vs. FOLFOX-4 (HR 0.61 (95% CI 0.35-1.07; p = 0.08)). For bevacizumab-XELOX vs. FOLFOX-4, this was not seen (stroma-low HR 1.07 (95% CI 0.64-1.77; p = 0.80); stroma-high HR 0.78 (95% CI 0.47-1.30; p = 0.35)). OS showed the same pattern for bevacizumab-FOLFOX-4 vs. FOLFOX-4 with a HR of 2.53 (95% CI 1.36-4.71; p = 0.003) for stroma-low and HR 0.50 (95% CI 0.22-1.14; p = 0.10) for stroma-high tumours. For bevacizumab-XELOX vs. FOLFOX-4, HR 1.13 (95% CI 0.55-2.31; p = 0.74) for stroma-low tumours and HR 0.74 (95% CI 0.37-1.51; p = 0.41) for stroma-high tumours.
conclusionsThis exploratory analysis suggests a significantly shorter DFS and OS in stroma-low tumours with addition of bevacizumab to intravenous oxaliplatin-based chemotherapy, contrary to stroma-high tumours, where a beneficial trend is observed.
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