ArticleBMC cancer2022
Tumour stroma ratio is a potential predictor for 5-year disease-free survival in breast cancer.
Article in BMC cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Significance of Tumor-Stroma Ratio (TSR) in Predicting Outcomes of Malignant Tumors.Medicina (Kaunas, Lithuania) · 2023Pooled it
- The Predictive Value of the Tumor-Stroma Ratio for Neoadjuvant Endocrine Therapy in Hormone Receptor-Positive Breast Cancer.International journal of cancer · 2026Article
- Added value of the tumor-stroma ratio to the PREDICT model for breast cancer.Breast (Edinburgh, Scotland) · 2026Article
- Exploring the 89Zr/177Lu Theranostic Pairing with an Extracellular Matrix-Targeted Radiopharmaceutical against Triple-Negative Breast Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Artificial intelligence-based tumor-stroma ratio quantification reveals prognostic value and stromal-driven immunosuppression in colorectal cancer: an international validation study.Journal of translational medicine · 2026Article
- Integration of the GRIm Score with Pathologic Immune and Stromal Markers to Develop a Combined Prognostic Model in Gastric Cancer: A Retrospective Single-Center Study.Medicina (Kaunas, Lithuania) · 2026Article
- Predictive value of tumor-infiltrating lymphocytes combined with tumor-stromal ratio for axillarylymph node metastasis in breast cancer patients - a retrospective cohort study.World journal of surgical oncology · 2025Article
- Nomogram for predicting tumor-stroma ratio in pancreatic ductal adenocarcinoma using dual-energy computed tomography.BMC medical imaging · 2025Article
- MCL-1 as a molecular switch between myofibroblastic and pro-angiogenic features of breast cancer-associated fibroblasts.Cell death & disease · 2025Article
- Targeting Extra Domain A of Fibronectin to Improve Noninvasive Detection of Triple-Negative Breast Cancer.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2025Article
- Digital Whole Slide Image Analysis of Elevated Stromal Content and Extracellular Matrix Protein Expression Predicts Adverse Prognosis in Triple-Negative Breast Cancer.International journal of molecular sciences · 2024Article
- Dissection of the signal transduction machinery responsible for the lysyl oxidase-like 4-mediated increase in invasive motility in triple-negative breast cancer cells: mechanistic insight into the integrin-β1-NF-κB-MMP9 axis.Frontiers in oncology · 2024Article
- Combining the tumor-stroma ratio with tumor-infiltrating lymphocytes improves the prediction of pathological complete response in breast cancer patients.Breast cancer research and treatment · 2023Article
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- Tumor-stroma ratio predicts prognosis and PD-L1 expression in hepatocellular carcinoma.BMC cancer · 2023Article
- Machine Learning Quantified Tumor-Stroma Ratio Is an Independent Prognosticator in Muscle-Invasive Bladder Cancer.International journal of molecular sciences · 2023Article
- Utility of Indigenously Developed Square Grid Method for Evaluation of Tumor-Stroma Ratio and Stromal Tumor-Infiltrating Lymphocytes in Invasive Breast Carcinoma: A Pilot Study.Iranian journal of pathology · 2023Article
- Increases prognostic value of clinical-pathological nomogram in patients with esophageal squamous cell carcinoma.Frontiers in oncology · 2023Article
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7 authors.
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Abstract
backgroundThe tumour-stroma ratio (TSR) is identified as a promising prognostic parameter for breast cancer, but the cutoff TSR value is mostly assessed by visual assessment, which lacks objective measurement. The aims of this study were to optimize the cutoff TSR value, and evaluate its prognosis value in patients with breast cancer both as continuous and categorical variables.
methodsMajor clinicopathological and follow-up data were collected for a series of patients with breast cancer. Tissue microarray images stained with cytokeratin immunohistochemistry were evaluated by automated quantitative image analysis algorithms to assess TSR. The potential cutoff point for TSR was optimized using maximally selected rank statistics. The association between TSR and 5-year disease-free survival (5-DFS) was assessed by Cox regression analysis. Kaplan-Meier analysis and log-rank test were used to assess the significance in survival analysis.
resultsThe optimal cut-off TSR value was 33.5%. Using this cut-off point, categorical variable analysis found that low TSR (i.e., high stroma, TSR ≤ 33.5%) predicts poor outcomes for 5-DFS (hazard ratio [HR] = 2.82, 95% confidence interval [CI] = 1.81-4.40, P = 0.000). When TSR was considered as a continuous parameter, results showed that increased stroma content was associated with worse 5-DFS (HR = 1.71, 95% CI = 1.34-2.18, P = 0.000). Similar results were also obtained in three molecular subtypes in continuous and categorical variable analyses. Moreover, in the Kaplan-Meier analysis, log-rank test showed that low TSR displayed a worse 5-DFS than high TSR (P = 0.000). Similar results were also obtained in patients with triple-negative breast cancer, human epidermal growth factor receptor 2 (HER2)-positive breast cancer, and luminal-HER2-negative breast cancer.
conclusionTSR is an independent predictor for 5-DFS in breast cancer with worse survival outcomes in low TSR. The prognostic value of TSR was also observed in other three molecular subtypes.
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