University of Oulu

Kemi, N., Eskuri, M., Herva, A. et al. Tumour-stroma ratio and prognosis in gastric adenocarcinoma. Br J Cancer 119, 435–439 (2018) doi:10.1038/s41416-018-0202-y

Tumour-stroma ratio and prognosis in gastric adenocarcinoma

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Author: Kemi, Niko1; Eskuri, Maarit1; Herva, Anni1;
Organizations: 1Cancer and Translational Medicine Research Unit, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
2Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Springer Nature, 2018
Publish Date: 2019-11-07


Background: Tumour microenvironment, including tumour–stroma ratio (TSR), might help identifying high-risk cancer patients. However, the significance of TSR in gastric cancer is unclear, especially in the intestinal and diffuse subtypes. The aim of this study was to investigate the tumour–stroma ratio in gastric adenocarcinoma, and its intestinal and diffuse histological subtypes, in relation to prognosis.

Methods: Five hundred and eighty-three gastric adenocarcinoma patients who underwent surgery in Oulu University hospital during years 1983–2016 were included in this retrospective cohort study. TSR was analysed from the slides that were originally used for diagnostic purposes. Patients were divided into stroma-poor (≤50% stroma) and stroma-rich (>50% stroma) groups and TSR was analysed in relation to 5-year mortality and overall mortality.

Results: Patients with stroma-rich tumours had worse 5-year prognosis (HR 1.80, 95% CI 1.41–2.28) compared to stroma-poor tumours. Stratified analysis showed that stroma-rich tumours had worse 5-year prognosis in both intestinal (HR 1.68, 95% CI 1.24–2.27) and diffuse histological types (HR 2.09, 95% CI 1.35–3.23) compared to stroma-poor tumours, respectively.

Conclusions: High proportion of stroma is an independent prognostic factor in both intestinal and diffuse histological subtypes of gastric adenocarcinoma.

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Series: British journal of cancer
ISSN: 0007-0920
ISSN-E: 1532-1827
ISSN-L: 0007-0920
Volume: 119
Issue: 4
Pages: 435 - 439
DOI: 10.1038/s41416-018-0202-y
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
3126 Surgery, anesthesiology, intensive care, radiology
Funding: This study was supported by grants from Sigrid Jusélius Foundation (to J.H.K.), Orion Research Foundation (to J.H.K.), Thelma Mäkikyrö Foundation (to J.H.K. and H.H.) and Mary and Georg C. Ehrnroot Foundation (to J.H.K.).
Copyright information: © Cancer Research UK 2018. This work is published under the standard license to publish agreement. After12 months the work will become freely available and the license terms will switch toa Creative Commons Attribution 4.0 International (CC BY 4.0).