TY - JOUR
AR - COR-2020-4-112
TI - Prognostic and Predictive Value of the Tumor-Stroma Ratio in STAGE II Colon Cancer
AU - Armin , Gerger
AU - Austrian Breast and , Colorectal Cancer Study Group (ABCSG)
AU - Evelyne , Bareck
AU - Gabi W. , van Pelt
AU - Hans , Rabl
AU - Hans , Gelderblom
AU - Klaus , Geissler
AU - Martin , Filipits
AU - Michael , Gnant
AU - Peter , Götzinger
AU - Renate , Schaberl-Moser
AU - Richard , Greil
AU - Rob A. , Tollenaar
AU - Stefan W. , de Vroome
AU - Stéphanie M., Zunder
AU - Thomas , Bachleitner-Hofmann
AU - Wilma E. , Mesker
AU - Wolfgang , Hilbe
JO - Clinical Oncology and Research
PY - 2020
DA - Thu 30, Apr 2020
SN - 2613-4942
DO - http://dx.doi.org/10.31487/j.COR.2020.04.12
UR - https://www.sciencerepository.org/prognostic-and-predictive-value-of-the-tumor-stroma-ratio-in_COR-2020-4-112 
KW - Colon cancer, tumor stroma, biomarker, treatment, prognosis, prediction
AB - Background: Tumor-stroma ratio (TSR) is an independent prognosticator in colon cancer.
Objective: We set out to investigate the predictive power, as well as to validate the prognostic power of
TSR in stage II colon cancer patients. Better identification of patients who could benefit from adjuvant
chemotherapy remains an important issue in stage II disease.
Methods: TSR was microscopically determined on haematoxylin and eosin-stained primary tumor tissue
slides of 212 patients who received either adjuvant chemotherapy or surveillance after curative resection in
a prospective randomized clinical trial (ABCSG-91).
Results: Stroma-high tumors were associated with significantly more cancer-related death ((CaDeath) HR
2.30, 95% CI 1.05−5.03; p=0.037) and significantly shorter distant recurrence-free survival ((DRFS) HR
2.32, 95% CI 1.10−4.87; p=0.027) compared to stroma-low tumors. Backward multivariate Cox-regression
analysis demonstrated TSR as an independent prognosticator for DRFS (p=0.027) and CaDeath (p=0.031).
TSR did not validate as a predictive biomarker; CaDeath (HR 0.87, 95% CI 0.18−4.17; p=0.87), DRFS (HR
0.76, 95% CI 0.17−3.36; p=0.71) and OS (HR 0.96, 95% CI 0.29−3.21; p=0.95) for the type of
chemotherapy given in ABCSG-91.
Conclusions: TSR, an easily applicable and inexpensive observer-based method, is an independent
predictor of poor prognosis in stage II colon cancer. Predictive value for adjuvant 5-FU/leucovorin could
not be demonstrated.