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The prognostic value of the tumour-stroma ratio in primary operable invasive cancer of the breast: a validation study

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Abstract

Purpose

The primary aim of the current study is to validate the prognostic relevance of the relative amount of tumour-associated stroma, the tumour-stroma ratio, in a large cohort of primary operable breast cancer patients.

Methods

A retrospective cohort study was performed on women diagnosed and treated for primarily operable invasive breast cancer in the period from 1 January 1990 till 31 December 1999. Tumour-stroma ratio was estimated by microscopic evaluation of haematoxylin and eosin tumour slides. Two independent observers (k = 0.68) performed tumour-stroma ratio evaluation in a significant part of the cohort. The prognostic potential with respect to overall, recurrence-free and distant metastasis-free survival was evaluated.

Results

A total of n = 737 women were evaluated. Median follow-up time was 11.5 years. High stromal content was an independent prognosticator for worse overall (hazard ratio 1.56, p = 0.002, 95% confidence interval 1.18–2.05), distant metastasis-free (hazard ratio 1.52, p = 0.008, 95% confidence interval 1.12–2.06) and recurrence-free survival (hazard ratio 1.35, p = 0.046, 95% confidence interval 1.01–1.81). In subgroups of hormone receptor-positive and lymph node-negative cases, high stromal content was also an independent prognosticator for worse outcome.

Conclusion

Tumour-stroma ratio is an independent risk factor for worse overall, distant metastasis-free and recurrence-free survival in primarily operable breast cancer. However, detailed prospective studies with respect to tumour-stroma ratio are necessary to gain more insight in its prognostic potential in clinical practice.

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Authors and Affiliations

  1. Department of Surgery, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands

    Toni Roeke, Rob A. E. M. Tollenaar & Wilma E. Mesker

  2. Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, The Netherlands

    Marcelo Sobral-Leite, Jelle Wesseling & Marjanka K. Schmidt

  3. Department of Pathology, Leiden University Medical Centre, Albinusdreef 2, Leiden, The Netherlands

    Tim J. A. Dekker & Vincent T. H. B. M. Smit

Authors
  1. Toni Roeke
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  2. Marcelo Sobral-Leite
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  3. Tim J. A. Dekker
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  4. Jelle Wesseling
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  5. Vincent T. H. B. M. Smit
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  6. Rob A. E. M. Tollenaar
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  7. Marjanka K. Schmidt
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  8. Wilma E. Mesker
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Correspondence to Wilma E. Mesker.

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All authors declare that they have no conflict of interest.

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Roeke, T., Sobral-Leite, M., Dekker, T.J.A. et al. The prognostic value of the tumour-stroma ratio in primary operable invasive cancer of the breast: a validation study. Breast Cancer Res Treat 166, 435–445 (2017). https://doi.org/10.1007/s10549-017-4445-8

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  • DOI: https://doi.org/10.1007/s10549-017-4445-8

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