ArticleCancer & metabolism2024
The relationship between Stroma AReactive Invasion Front Areas (SARIFA), Warburg-subtype and survival: results from a large prospective series of colorectal cancer patients.
Article in Cancer & metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Direct tumour-adipocyte contact / Stroma AReactive Invasion Front Area (TAC/SARIFA) predicts adverse outcome in colorectal cancer: a focused evidence synthesis and meta-analysis.Histopathology · 2026Pooled it
- The Association of SARIFA with Poor Prognosis and Aggressive Tumor Phenotypes in Cancers: A Meta-Analysis.Journal of clinical medicine · 2026Review
- Energy Balance-Related Factors and Direct Tumor-Adipocyte Contact in Colorectal Cancer: Etiologic Insights from the Population-Based Netherlands Cohort Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Distinct NK cell dynamics in SARIFA positive colorectal cancer patients indicate persistent patient-intrinsic immune signatures after tumor resection.Scientific reports · 2026Article
- Deep learning-based H&E-derived risk scores in colorectal cancer: associations with tumour morphology, biology, and predicted drug response.The Journal of pathology · 2026Article
- [SARIFA: Literature review and expert opinion on the new morphological biomarker].Pathologie (Heidelberg, Germany) · 2026Review
- Tissue-Based Multiomic Exploratory Analysis of the Urokinase Plasminogen Activator/uPAR System and Matrix Metalloproteinases in Stroma AReactive Invasion Front Areas-Positive Gastrointestinal Cancers.Pathobiology : journal of immunopathology, molecular and cellular biology · 2026Article
- Stroma areactive invasion front areas (SARIFA) in 1,298 pT3/pT4 colorectal cancers: A strong prognostic parameter complementing established morphological criteria.Histopathology · 2025Article
- Stroma AReactive Invasion Front Areas (SARIFA) and the tumour immune microenvironment in colorectal cancer.British journal of cancer · 2025Article
- Prognostic and Predictive Value of SARIFA-status Within Molecular Subgroups of Colorectal Cancer: Insights From the Netherlands Cohort Study.The American journal of surgical pathology · 2025Article
- [SARIFA-a new multi-entity biomarker].Pathologie (Heidelberg, Germany) · 2024Review
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundStroma AReactive Invasion Front Areas (SARIFA) is a recently identified haematoxylin & eosin (H&E)based histopathologic biomarker in gastrointestinal cancers, including colorectal cancer (CRC), defined as direct contact between tumour cells and adipocytes at the tumour invasion front. The current study aimed at validating the prognostic relevance of SARIFA in a large population-based CRC series as well as at investigating the relationship between SARIFA-status and previously established Warburg-subtypes, both surrogates of the metabolic state of the tumour cells.
methodsSARIFA-status (positive versus negative) was determined on H&E slides of 1,727 CRC specimens. Warburg-subtype (high versus moderate versus low) data was available from our previous study. The associations between SARIFA-status, Warburg-subtype, clinicopathological characteristics and CRC-specific as well as overall survival were investigated.
results28.7% (n=496) CRC were SARIFA-positive. SARIFA-positivity was associated with more advanced disease stage, higher pT category, and more frequent lymph node involvement (all p<0.001). SARIFA-positivity was more common in Warburg-high CRC. 44.2% (n=219) of SARIFA-positive CRCs were Warburg-high compared to 22.8% (n=113) being Warburg-low and 33.1% (n=164) being Warburg-moderate (p<0.001). In multivariable-adjusted analysis, patients with SARIFA-positive CRCs had significantly poorer CRC-specific (HR
conclusionsOur current study is the by far largest external validation of SARIFA-positivity as a novel independent negative prognostic H&E-based biomarker in CRC. In addition, our study shows that SARIFA-positivity is associated with the Warburg-high subtype. Further research is warranted to provide a more mechanistic understanding of the underlying tumour biology. Based on our data, we conclude SARIFA-status should be implemented in pathologic routine practice to stratify CRC patients.
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