ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2022
A high tumour-stroma ratio (TSR) in colon tumours and its metastatic lymph nodes predicts poor cancer-free survival and chemo resistance.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- A scoping review of TSR analysis in colorectal cancer: implications for automated solutions.Oncology reviews · 2025Pooled it
- Therapeutic Strategies Targeting the Tumor-Stromal Microenvironment in Colorectal Cancer: A Narrative Review.Targeted oncology · 2026Review
- Automating tumor-stroma ratio quantification in colon cancer patients from the UNITED study.ESMO open · 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
- Multidimensional differences of right- and left-sided colorectal cancer and their impact on targeted therapies.NPJ precision oncology · 2025Review
- Self-supervised learning reveals clinically relevant histomorphological patterns for therapeutic strategies in colon cancer.Nature communications · 2025Article
- Tumor-stroma ratio in colitis-associated colorectal cancer.Upsala journal of medical sciences · 2025Article
- Tumour-stroma ratio (TSR) in breast cancer: comparison of scoring core biopsies versus resection specimens.Virchows Archiv : an international journal of pathology · 2024Article
- Results from the UNITED study: a multicenter study validating the prognostic effect of the tumor-stroma ratio in colon cancer.ESMO open · 2024Article
- Cellular and Molecular Mechanisms of the Tumor Stroma in Colorectal Cancer: Insights into Disease Progression and Therapeutic Targets.Biomedicines · 2023Review
- Node-negative colon cancer: histological, molecular, and stromal features predicting disease recurrence.Molecular medicine (Cambridge, Mass.) · 2023Article
- Development of Tier 2 LC-MRM-MS protein quantification methods for liquid biopsies.Journal of mass spectrometry and advances in the clinical lab · 2023Article
- KIT promotes tumor stroma formation and counteracts tumor-suppressive TGFβ signaling in colorectal cancer.Cell death & disease · 2022Article
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10 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeDespite known high-risk features, accurate identification of patients at high risk of cancer recurrence in colon cancer remains a challenge. As tumour stroma plays an important role in tumour invasion and metastasis, the easy, low-cost and highly reproducible tumour-stroma ratio (TSR) could be a valuable prognostic marker, which is also believed to predict chemo resistance.
methodsTwo independent series of patients with colon cancer were selected. TSR was estimated by microscopic analysis of 4 µm haematoxylin and eosin (H&E) stained tissue sections of the primary tumour and the corresponding metastatic lymph nodes. Patients were categorized as TSR-low (≤ 50%) or TSR-high (> 50%). Differences in overall survival and cancer-free survival were analysed by Kaplan-Meier curves and cox-regression analyses. Analyses were conducted for TNM-stage I-II, TNM-stage III and patients with an indication for chemotherapy separately.
resultsWe found that high TSR was associated with poor cancer-free survival in TNM-stage I-II colon cancer in two independent series, independent of other known high-risk features. This association was also found in TNM-stage III tumours, with an additional prognostic value of TSR in lymph node metastasis to TSR in the primary tumour alone. In addition, high TSR was found to predict chemo resistance in patients receiving adjuvant chemotherapy after surgical resection of a TNM-stage II-III colon tumour.
conclusionIn colon cancer, the TSR of both primary tumour and lymph node metastasis adds significant prognostic value to current pathologic and clinical features used for the identification of patients at high risk of cancer recurrence, and also predicts chemo resistance.
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