Tumor-Stroma Ratio is an independent predictor for overall survival and disease free survival in gastric cancer patients
Tumor-Stroma Ratio is an independent predictor for overall survival and disease free survival in gastric cancer patients
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DOI：
10.1016/j.surge.2017.05.007
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发表时间：
2017-12-01
影响因子：
2.5
通讯作者：
Ramacciato, Giovanni
中科院分区：
文献类型：
--
作者：
Aurello, Paolo;Berardi, Giammauro;Ramacciato, Giovanni
背景资料：尽管已经研究了不同的预后因素，但接受潜在根治性切除术的胃癌患者的预后仍然很差。因此，有必要确定新的预后因素。近年来，肿瘤-间质比（TSR）被证明与不同类型癌症的预后相关。本研究的目的是评估TSR在胃癌患者中的预后价值。方法：106例患者在2004年1月至2015年12月期间接受胃切除术。收集人口统计学和组织病理学特征。结果：41例（38.7%）患者被划分为间质贫乏组，65例（61.3%）被划分为间质丰富组（61.3%）。间质丰富组患者的阳性淋巴结数、淋巴结比率（LNR）、T3/T4局部浸润率和N2/N3比值较高，TNM分期较晚。此外，这些患者表现出较高比例的淋巴血管和神经浸润。中位随访时间为38个月，与基质贫乏患者相比，基质丰富患者的5年精算总生存期（OS）和无病生存期（DFS）显著更差。此外，多因素分析显示，基质丰富是唯一的独立因素与OS和DFS连同TNM分期。结论：TSR是一个独立的标志物，胃癌患者的预后不良，应很容易纳入常规的临床病理报告。对于接受根治性胃切除术且复发风险高的患者，识别敏感标志物可为手术或强化和/或靶向辅助化疗后计划随访提供有用信息。(C)2017年爱丁堡皇家外科学院（苏格兰慈善机构编号SC 005317）和爱尔兰的皇家外科学院。由爱思唯尔有限公司发布。保留所有权利。
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. (C) 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.