University of Oulu

Kemi, N., Eskuri, M. & Kauppila, J.H. Tumour-stroma ratio and 5-year mortality in gastric adenocarcinoma: a systematic review and meta-analysis. Sci Rep 9, 16018 (2019).

Tumour-stroma ratio and 5-year mortality in gastric adenocarcinoma : a systematic review and meta-analysis

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Author: Kemi, Niko1; Eskuri, Maarit1; Kauppila, Joonas H.1,2
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, 1.1 MB)
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Language: English
Published: Springer Nature, 2019
Publish Date: 2020-04-22


Tumour-stroma ratio (TSR) is a novel potential prognostic factor in cancers and based on the proportions of stroma and tumour area. The prognostic value of TSR in gastric cancer is incompletely known. The aim of this study was to estimate prognostic significance of TSR in gastric adenocarcinoma. A search of PubMed (MEDLINE), Web of Science, EMBASE, Cochrane and Scopus databases was performed. A meta-analysis was conducted on five-year survival in gastric cancer patients using inverse variance random-effects methods. The literature search yielded 5329 potential titles, of which a total of seven studies were eligible. Results of six studies including a total of 1779 patients were pooled in the meta-analysis. Only 23 (1.3%) of the patients received neoadjuvant therapy. All six studies had a cut-off of 50% for the proportion of stroma when dividing the patients into low- and high stroma groups. Low TSR (high amount of stroma) was strongly associated with increased five-year mortality (hazard ratio 2.19, 95% CI 1.69–2.85). In conclusion, TSR is a strong prognostic factor in gastric cancer. It could be used to estimate prognosis of gastric cancer patients not receiving neoadjuvant chemotherapy. Further studies including patients receiving neoadjuvant therapy are recommended.

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Series: Scientific reports
ISSN: 2045-2322
ISSN-E: 2045-2322
ISSN-L: 2045-2322
Volume: 9
Article number: 16018
DOI: 10.1038/s41598-019-52606-7
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: This study was supported by grants from Sigrid Jusélius Foundation (JHK), Orion Research Foundation (JHK), The Finnish Cancer Foundation (JHK), Thelma Mäkikyrö Foundation (JHK) and Mary and Georg C. Ehrnroot Foundation (JHK). The study sponsors had no role in the design of the study, data collection, analysis or interpretation of the results, the writing of the manuscript or the decision to submit the manuscript for publication.
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