Scheer, R. (2012) THE TUMOR-STROMA RATIO AS PROGNOSTIC FACTOR IN RECTAL CANCER. thesis, Medicine.
Full text available on request.Abstract
Background: The TNM staging system is used to discriminate between patients with a better and a poor prognosis, but additional prognostic factors are desirable. The tumor-stroma ratio (TSR) has proven to be of prognostic value in several malignancies. The prognostic value of the TSR in rectal cancer and decisions in its determination were analyzed in this study. Methods: In this retrospective study the carcinoma percentage (CP), a derivative of the TSR, was determined on H&E stained histological sections of the surgical specimens of 154 patients treated for rectal adenocarcinoma under the peritoneal reflection. All patients were treated with curative intent without neoadjuvant treatment in the period 1996-2006. The CPs were determined in different layers of the rectal wall with attention to necrosis at the point of highest tumor infiltration and at the border of the tumor. CPs were categorized into three categories: CP-low, CP-moderate and CP-high. Results: The TSR based on the total coupe at the point of highest tumor infiltration and necrosis discounted has the most distinctive prognostic value. Patients with a high TSR showed significantly better five year survival rates for overall survival (p = 0.010) and disease specific survival (p = 0.023) and a trend to a longer disease free (p = 0.061) compared with CP-moderate and CP-low. In a multivariate Cox regression analysis the TSR did not remain an independent prognostic factor when adjusted for age, pT-status, pN-status, grading and adjuvant treatment. Conclusion: The TSR has the potential to contribute in identifying patients with a better and a poorer prognosis and so in decision making about an individual adjuvant treatment policy in rectal cancer.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Klaase, J.M. MD and Location: and Medisch Spectrum Twente, Department of Surgery |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:55 |
| Last Modified: | 25 Jun 2020 10:55 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1545 |
Actions (login required)
 |
View Item |