Myxoid stroma is associated with postoperative relapse in patients with stage II colon cancer

Abstract

Background: Fibrosis surrounding cancer cells has been shown to affect cancer cell metastatic behavior. The present study aimed to explore the utility of myxoid stroma as a predictive factor for postoperative relapse in patients with stage II colon cancer. Methods: The present study retrospectively investigated 169 patients who underwent curative surgical resection of stage II colon cancer. The fibrotic stroma was classified according to Ueno's criteria, and the patients were divided into the myxoid (MY) group and the non-MY (NMY) group. We also recorded tumor budding (TB) and investigated the combination of MY and TB for postoperative relapse. Postoperative survival was also explored. Results: Thirty-two (18.9%) patients had MY. MY was significantly associated with tumor budding (TB) and postoperative relapse (p < 0.001 and p < 0.001, respectively). The 5-year RFS rates in MY group and NMY group were 52.1 and 94.6% (p < 0.0001), and the 5-year OS rates in MY group and NMY group were 74.6 and 93.3% (p = 0.001). Multivariate analysis showed that both MY and TB were significant risk factors for postoperative relapse (p < 0.001 and p = 0.02, respectively), and that only TB was a significant risk factor for OS (p = 0.043). Furthermore, compared with patients with either one of MY or TB, patients with both MY and TB had postoperative relapse more frequently (11.4% vs. 53.8%). Conclusions: The present study suggests that MY is a predictive marker for postoperative relapse in patients with stage II colon cancer.

Polarimetric biomarkers of peri-tumoral stroma can correlate with 5-year survival in patients with left-sided colorectal cancer

“…However, multiple studies highlighting inadequate performance of most of these tests, along with their high costs 9 , 10 , drive the search for alternative sources of prognostic information. In this context, increasing evidence supports the prognostic value contained within the tumour micro-environment, such as tumour stromal architecture 11 – 15 , more specifically desmoplasia or the desmoplastic response (DR) 16 – 19 . DR is associated with the growth and structural remodeling of collagenous stroma in the most invasive tumour front regions.…”

“…Assessing DR involves a three-class categorization of stromal maturity: immature, intermediate, and mature, where 5-year relapse-free survival (RFS) was found to correlate with stromal maturity 9 – 12 . Recent studies suggest DR as a RFS prognostic factor, independent of TNM staging and tumour grade 16 – 19 . However, despite its promise, assessing DR (either qualitatively or quantitatively) suffers from analysis subjectivity and inter-observer variability, making its clinical uptake difficult.…”

Machine learning based local recurrence prediction in colorectal cancer using polarized light imaging

“… – 13 Known as the desmoplastic response (DR), this growth and structural remodeling of connective tissue has been shown to correlate with 5-year relapse-free survival and LR 14 – 17 DR utilizes a three-class categorization of stromal maturity (immature, intermediate, and mature). However, given the qualitative and subjective nature of its assessment, DR has not witnessed widespread clinical adoption primarily due to inter-observer variability.…”