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Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients

  • Authors:
    • An Shang
    • Pengcheng Yu
    • Liping Li
    • Ge He
    • Junyi Xu
  • View Affiliations / Copyright

    Affiliations: Department of General Surgery, The Fourth Hospital of Guangxi Medical University, Liuzhou, Guangxi 545007, P.R. China, Department of Pneumology, The Fourth Hospital of Guangxi Medical University, Liuzhou, Guangxi 545007, P.R. China
    Copyright: © Shang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 190
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    Published online on: February 19, 2025
       https://doi.org/10.3892/ol.2025.14936
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Abstract

The tumor‑stroma ratio (TSR) has been regarded as an important factor associated with tumor metastasis, based on the ‘seed and soil’ theory, which may have guiding significance for the selection of chemotherapy regimens. Therefore, a high TSR may be a new risk factor for tumor recurrence in patients with stage II colorectal cancer (CRC). The present study aimed to evaluate the prognostic value of TSR in CRC, especially for the computer‑calculated TSR. A comprehensive literature retrieval was performed using the PubMed, Web of Science, Embase and Cochrane Library databases to identify relevant studies published up to December 13, 2023. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to estimate the prognostic value of the TSR in CRC. A total of 21 studies published between 2007 and 2023 were included in the present meta‑analysis. The combined analysis demonstrated that a high TSR was significantly associated with worse overall survival (OS; HR=1.84; 95% CI, 1.44‑2.34; P<0.001), disease‑free survival (DFS; HR=1.85; 95% CI, 1.27‑2.68; P<0.001), cancer‑specific survival (CSS; H=1.97; 95% CI, 1.46‑2.65; P<0.001) and recurrence free survival (RFS; HR=1.55; 95% CI, 1.25‑1.92; P<0.001) in patients with CRC. Moreover, an elevated computer‑calculated TSR was also associated with poor OS (HR=1.89; 95% CI, 1.48‑2.40; P<0.001) and DFS (HR=1.85; 95% CI, 1.27‑2.68; P<0.001). However, a high TSR was not associated with poor OS in patients with stage I CRC (HR=1.01; 95% CI, 0.48‑2.14; P=0.97). In conclusion, the results of the present meta‑analysis indicate that a high TSR is associated with poor OS, DFS, CSS and RFS in patients with CRC, especially for those with stage II‑III. In addition, TSR calculated by computer using whole‑slide images may also be an effective prognostic marker for OS and DFS in patients with CRC.
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Copy and paste a formatted citation
Spandidos Publications style
Shang A, Yu P, Li L, He G and Xu J: Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients. Oncol Lett 29: 190, 2025.
APA
Shang, A., Yu, P., Li, L., He, G., & Xu, J. (2025). Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients. Oncology Letters, 29, 190. https://doi.org/10.3892/ol.2025.14936
MLA
Shang, A., Yu, P., Li, L., He, G., Xu, J."Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients". Oncology Letters 29.4 (2025): 190.
Chicago
Shang, A., Yu, P., Li, L., He, G., Xu, J."Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients". Oncology Letters 29, no. 4 (2025): 190. https://doi.org/10.3892/ol.2025.14936
Copy and paste a formatted citation
x
Spandidos Publications style
Shang A, Yu P, Li L, He G and Xu J: Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients. Oncol Lett 29: 190, 2025.
APA
Shang, A., Yu, P., Li, L., He, G., & Xu, J. (2025). Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients. Oncology Letters, 29, 190. https://doi.org/10.3892/ol.2025.14936
MLA
Shang, A., Yu, P., Li, L., He, G., Xu, J."Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients". Oncology Letters 29.4 (2025): 190.
Chicago
Shang, A., Yu, P., Li, L., He, G., Xu, J."Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients". Oncology Letters 29, no. 4 (2025): 190. https://doi.org/10.3892/ol.2025.14936
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