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The proportion of tumor-stroma as a strong prognosticator for stage II and III colon cancer patients : validation in the VICTOR trial
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Huijbers, A., Tollenaar, R. A. E. M., v Pelt, G. W., Zeestraten, E. C. M., Dutton, S., McConkey, Christopher C., Domingo, E., Smit, V. T. H. B. M., Midgley, R., Warren, B. F., Johnstone, E. C., Kerr, D. J. and Mesker, W. E. (2013) The proportion of tumor-stroma as a strong prognosticator for stage II and III colon cancer patients : validation in the VICTOR trial. Annals of Oncology, Volume 24 (Number 1). pp. 179-185. doi:10.1093/annonc/mds246 ISSN 0923-7534.
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Official URL: http://dx.doi.org/10.1093/annonc/mds246
Abstract
Background: The intra-tumor stroma percentage in colon cancer (CC) patients has previously been reported by our group as a strong independent prognostic parameter. Patients with a high stroma percentage within the primary tumor have a poor prognosis.
Patients and methods: Tissue samples from the most invasive part of the primary tumor of 710 patients (52% Stage II, 48% Stage III) participating in the VICTOR trial were analyzed for their tumor-stroma percentage. Stroma-high (>50%) and stroma-low (≤50%) groups were evaluated with respect to survival times.
Results: Overall and disease-free survival times (OS and DFS) were significantly lower in the stroma-high group (OS P < 0.0001, hazard ratio (HR) = 1.96; DFS P < 0.0001, HR = 2.15). The 5-year OS was 69.0% versus 83.4% and DFS 58.6% versus 77.3% for stroma-high versus stroma-low patients.
Conclusion: This study confirms the intra-tumor stroma ratio as a prognostic factor. This parameter could be a valuable and low cost addition to the TNM status and next to current high-risk parameters such as microsatellite instability status used in routine pathology reporting. When adding the stroma-parameter to the ASCO criteria, the rate of ‘undertreated’ patients dropped from 5.9% to 4.3%, the ‘overtreated’ increased with 6.8% but the correctly classified increased with an additional 14%.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Annals of Oncology | ||||
Publisher: | Oxford University Press | ||||
ISSN: | 0923-7534 | ||||
Official Date: | 2013 | ||||
Dates: |
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Volume: | Volume 24 | ||||
Number: | Number 1 | ||||
Page Range: | pp. 179-185 | ||||
DOI: | 10.1093/annonc/mds246 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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