Significance of Tumor-Stroma Ratio (TSR) in Predicting Outcomes of Malignant Tumors

• Published in: Medicina (Kaunas, Lithuania) Vol. 59; no. 7; p. 1258
• Main Authors: Pyo, Jung-Soo, Kim, Nae Yu, Min, Kyueng-Whan, Kang, Dong-Wook
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.07.2023; MDPI
• Subjects: Analysis; Cancer; Colorectal Neoplasms; Development and progression; Disease-Free Survival; Endometrial cancer; Endometrial Neoplasms; Esophagus; Extracellular matrix; Female; Humans; malignant tumor; Medical prognosis; Meta-analysis; Metastasis; Ovaries; Prognosis; Proportional Hazards Models; Stomach Neoplasms; Tumors; tumor–stroma ratio; meta-analysis; tumor–stroma ratio; malignant tumor; prognosis
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina59071258

The present study aimed to elucidate the distribution and the prognostic implications of tumor-stroma ratio (TSR) in various malignant tumors through a meta-analysis. This meta-analysis included 51 eligible studies with information for overall survival (OS) or disease-free survival (DFS), according to TSR. In addition, subgroup analysis was performed based on criteria for high TSR. The estimated rate of high TSR was 0.605 (95% confidence interval (CI) 0.565-0.644) in overall malignant tumors. The rates of high TSR ranged from 0.276 to 0.865. The highest rate of high TSR was found in endometrial cancer (0.865, 95% CI 0.827-0.895). The estimated high TSR rates of colorectal, esophageal, and stomach cancers were 0.622, 0.529, and 0.448, respectively. In overall cases, patients with high TSR had better OS and DFS than those with low TSR (hazard ratio (HR) 0.631, 95% CI 0.542-0.734, and HR 0.564, 95% CI 0.0.476-0.669, respectively). Significant correlations with OS were found in the breast, cervical, colorectal, esophagus, head and neck, ovary, stomach, and urinary tract cancers. In addition, there were significant correlations of DFS in breast, cervical, colorectal, esophageal, larynx, lung, and stomach cancers. In endometrial cancers, high TSR was significantly correlated with worse OS and DFS. The rate of high TSR was different in various malignant tumors. TSR can be useful for predicting prognosis through a routine microscopic examination of malignant tumors.