ArticleThe American journal of surgical pathology2025
Prognostic and Predictive Value of SARIFA-status Within Molecular Subgroups of Colorectal Cancer: Insights From the Netherlands Cohort Study.
Article in The American journal of surgical pathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 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
- [SARIFA: Literature review and expert opinion on the new morphological biomarker].Pathologie (Heidelberg, Germany) · 2026Review
- 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
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8 authors.
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Abstract
We recently proposed Stroma AReactive Invasion Front Areas (SARIFA), defined as direct tumor-adipocyte interaction at the invasion front, as a novel hematoxylin-and-eosin (H&E)-based histopathological prognostic biomarker in various cancers. Given that microsatellite instability, BRAF , and RAS mutation status are routinely tested for colorectal cancers (CRC), studying SARIFA's additional prognostic value within these molecular subgroups is crucial. In addition, exploring whether the survival benefit from adjuvant therapy differs according to SARIFA-status may enhance patient treatment and outcome. SARIFA-status, BRAF , RAS , and DNA mismatch repair (MMR) status were available for 1726 CRC patients from the prospective Netherlands Cohort Study (NLCS, 1986-2006). In this study, we investigated (1) the relationship between SARIFA-status and CRC molecular characteristics, (2) the prognostic value of SARIFA-status within these molecular subgroups, and (3) whether SARIFA-status was associated with survival benefit from adjuvant therapy. SARIFA-positive CRCs more frequently showed a BRAF mutation compared to SARIFA-negative CRCs ( P <0.001). BRAF -mutant/MMR-proficient CRCs were enriched in SARIFA-positive cases. SARIFA-positivity was associated with poor CRC-specific (HR range : 1.47 to 1.78) and overall survival (HR range : 1.35 to 1.70) within all molecular subgroups except MMR-deficient CRCs. Patients with SARIFA-positive CRC showed a CRC-specific survival benefit from adjuvant therapy compared to surgery alone (HR CRC-specific : 0.59; 95% CI: 0.44-0.79), while no CRC-specific survival benefit was observed for patients with SARIFA-negative CRC. To conclude, our results indicate that SARIFA-positivity is more common in the aggressive subset of BRAF -mutant and BRAF -mutant/MMR-proficient CRCs. Moreover, SARIFA-positivity provides additional prognostic value within molecular subgroups based on BRAF , RAS , and MMR status, suggesting that it may enhance prognostic stratification of CRC patients.
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