Paolo Aurello1, Giammauro Berardi2, Diego Giulitti1, Antonio Palumbo3, Simone Maria Tierno1, Giuseppe Nigri1, Francesco D'Angelo1, Emanuela Pilozzi3, Giovanni Ramacciato1. 1. Department of General Surgery, University of Rome, "La Sapienza", Sant'Andrea Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy. 2. Department of General Surgery, University of Rome, "La Sapienza", Sant'Andrea Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy. Electronic address: gberardi1@gmail.com. 3. Department of Pathology, University of Rome, "La Sapienza", Sant'Andrea Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy.
Abstract
BACKGROUND: Despite different prognostic factors have been already studied, patients undergoing potentially curative resection for gastric cancer, still have a poor outcome. There is therefore the need to identify novel prognostic factors. Recently, Tumor-Stroma Ratio (TSR) was proven to be associated with prognosis in different types of cancers. Aim of this study was to evaluate the prognostic value of TSR in gastric cancer patients. METHODS: 106 patients underwent gastrectomy between January 2004 and December 2015. Demographics and histopathological characteristics were collected. We considered a 50% TSR cutoff value to divide patients in Stroma-Rich (≥50%) and Stroma-Poor (<50%) groups. RESULTS: Forty-one (38.7%) patients were classified as Stroma-Poor while 65 (61.3%) as Stroma-Rich (61.3%). The Stroma-Rich patients had a higher number of positive lymph-nodes, lymph node ratio (LNR), a higher percentage of T3/T4 local invasion and N2/N3, and a more advanced TNM. Moreover, these patients showed a higher percentage of lymphovascular and perineural invasion. With a median FU of 38 months Stroma-Rich patients had a significantly worse 5-years actuarial overall survival (OS) and disease free survival (DFS) compared to Stroma-Poor patients. Moreover, the multivariate analysis showed that Stroma-Rich was the only independent factor associated with OS and DFS together with TNM-Stage. CONCLUSIONS: TSR is an independent marker of poor prognosis in patients with gastric cancer that should be readily incorporated into routine clinical pathology reporting. Identification of sensitive markers for patients who had undergone curative gastrectomy and who are at high risk of recurrence could provide useful information for planning follow-up after surgery or intensive and or/targeting adjuvant chemotherapy.
BACKGROUND: Despite different prognostic factors have been already studied, patients undergoing potentially curative resection for gastric cancer, still have a poor outcome. There is therefore the need to identify novel prognostic factors. Recently, Tumor-Stroma Ratio (TSR) was proven to be associated with prognosis in different types of cancers. Aim of this study was to evaluate the prognostic value of TSR in gastric cancerpatients. METHODS: 106 patients underwent gastrectomy between January 2004 and December 2015. Demographics and histopathological characteristics were collected. We considered a 50% TSR cutoff value to divide patients in Stroma-Rich (≥50%) and Stroma-Poor (<50%) groups. RESULTS: Forty-one (38.7%) patients were classified as Stroma-Poor while 65 (61.3%) as Stroma-Rich (61.3%). The Stroma-Richpatients had a higher number of positive lymph-nodes, lymph node ratio (LNR), a higher percentage of T3/T4 local invasion and N2/N3, and a more advanced TNM. Moreover, these patients showed a higher percentage of lymphovascular and perineural invasion. With a median FU of 38 months Stroma-Richpatients had a significantly worse 5-years actuarial overall survival (OS) and disease free survival (DFS) compared to Stroma-Poorpatients. Moreover, the multivariate analysis showed that Stroma-Rich was the only independent factor associated with OS and DFS together with TNM-Stage. CONCLUSIONS: TSR is an independent marker of poor prognosis in patients with gastric cancer that should be readily incorporated into routine clinical pathology reporting. Identification of sensitive markers for patients who had undergone curative gastrectomy and who are at high risk of recurrence could provide useful information for planning follow-up after surgery or intensive and or/targeting adjuvant chemotherapy.
Authors: Cor J Ravensbergen; Matthew Kuruc; Meaghan Polack; Stijn Crobach; Hein Putter; Hans Gelderblom; Devjit Roy; Rob A E M Tollenaar; Wilma E Mesker Journal: Cancers (Basel) Date: 2021-12-29 Impact factor: 6.639
Authors: Cor J Ravensbergen; Meaghan Polack; Jessica Roelands; Stijn Crobach; Hein Putter; Hans Gelderblom; Rob A E M Tollenaar; Wilma E Mesker Journal: Cells Date: 2021-10-28 Impact factor: 6.600
Authors: Kiki M H Vangangelt; Andrew R Green; Isabelle M F Heemskerk; Danielle Cohen; Gabi W van Pelt; Marcelo Sobral-Leite; Marjanka K Schmidt; Hein Putter; Emad A Rakha; Rob A E M Tollenaar; Wilma E Mesker Journal: Int J Cancer Date: 2020-01-22 Impact factor: 7.396