Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Ann Oncol. 2013 Jan;24(1):179-85. doi: 10.1093/annonc/mds246. Epub 2012 Aug 2.
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.
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.
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.
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%.
本研究组曾报道过结肠癌（CC）患者肿瘤内基质百分比是一个强有力的独立预后参数。原发肿瘤中基质百分比高的患者预后较差。
对 710 例（52%为 II 期，48%为 III 期）参与 VICTOR 试验的患者的原发肿瘤最侵袭部位的组织样本进行肿瘤基质百分比分析。根据基质百分比高低（>50%为高基质组，≤50%为低基质组）评估生存时间。
高基质组的总生存时间（OS）和无病生存时间（DFS）明显较低（OS P<0.0001，风险比（HR）=1.96；DFS P<0.0001，HR=2.15）。高基质组的 5 年 OS 为 69.0%，DFS 为 58.6%，而低基质组的 5 年 OS 为 83.4%，DFS 为 77.3%。
本研究证实肿瘤内基质比率是一个预后因素。该参数可作为 TNM 分期的有效、低成本补充，且可与当前常规病理报告中使用的微卫星不稳定性状态等高危参数一起使用。当将基质参数添加到 ASCO 标准中时，“治疗不足”的患者比例从 5.9%下降到 4.3%，“治疗过度”的患者比例增加了 6.8%，但正确分类的患者比例增加了 14%。
