ArticleBMC cancer2021
The value of the tumour-stroma ratio for predicting neoadjuvant chemoradiotherapy response in locally advanced rectal cancer: a case control study.
Article in BMC cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- A scoping review of TSR analysis in colorectal cancer: implications for automated solutions.Oncology reviews · 2025Pooled it
- Trial
- Added value of the tumor-stroma ratio to the PREDICT model for breast cancer.Breast (Edinburgh, Scotland) · 2026Article
- Combining tertiary lymphoid structures and tumor stroma percentage for predicting prognosis and chemotherapy benefits in stage II-III colorectal cancer.BMC cancer · 2026Article
- Tumour-Stroma Ratio as a Predictive Biomarker for Neoadjuvant Therapy Efficacy in Rectal Cancer.Cancers · 2026Review
- Overcoming the Challenge: A Comprehensive Review of Neoadjuvant Treatment Resistance in Rectal Cancer.Journal of gastrointestinal cancer · 2025Review
- The tumour-stroma ratio as predictive aid towards a biopsy-based treatment strategy in rectal carcinoma.Histopathology · 2025Article
- Tumor stroma ratio, tumor stroma maturity, tumor-infiltrating immune cells in relation to prognosis, and neoadjuvant therapy response in esophagogastric junction adenocarcinoma.Virchows Archiv : an international journal of pathology · 2025Article
- Cell type prediction with neighborhood-enhanced cellular embedding using deep learning on hematoxylin and eosin-stained images.Computational and structural biotechnology journal · 2025Article
- PD-1 blockade enhances the effect of targeted chemotherapy on locally advanced pMMR/MSS colorectal cancer.Cancer medicine · 2024Article
- Tumor-stroma ratio predicts prognosis and PD-L1 expression in hepatocellular carcinoma.BMC cancer · 2023Article
- Tumor Stroma Ratio and Its Significance in Locally Advanced Colorectal Cancer.Current oncology (Toronto, Ont.) · 2022Review
- Article
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12 authors at 7 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe tumour-stroma ratio (TSR) is recognized as a practical prognostic factor in colorectal cancer. However, TSR assessment generally utilizes surgical specimens. This study aims to investigate whether the TSR evaluated from preoperative biopsy specimens by a semi-automatic quantification method can predict the response after neoadjuvant chemoradiotherapy (nCRT) of patients with locally advanced rectal cancer (LARC).
methodsA total of 248 consecutive patients diagnosed with LARC and treated with nCRT followed by resection were included. Haematoxylin and eosin (HE)-stained sections of biopsy specimens were collected, and the TSR was evaluated by a semi-automatic quantification method and was divided into three categories, using the cut-offs determined in the whole cohort to balance the proportion of patients in each category. The response to nCRT was evaluated on the primary tumour resection specimen by an expert pathologist using the four-tier tumour regression grade (TRG) system.
resultsThe TSR can discriminate patients that are major-responders (TRG 0-1) from patients that are non-responders (TRG 2-3). Patients were divided into stroma-low (33.5%), stroma-intermediate (33.9%), and stroma-high (32.7%) groups using 56.3 and 72.8% as the cutoffs. In the stroma-low group, 58 (69.9%) patients were major-responders, and only 39 (48.1%) patients were considered major-responders in the stroma-high group (P = 0.018). Multivariate analysis showed that the TSR was the only pre-treatment predictor of response to nCRT (adjusted odds ratio 0.40, 95% confidence interval 0.21-0.76, P = 0.002).
conclusionAn elevated TSR in preoperative biopsy specimens is an independent predictor of nCRT response in LARC. This semi-automatic quantified TSR could be easily translated into routine pathologic assessment due to its reproducibility and reliability.
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