Scoring the tumor-stroma ratio in colon cancer: procedure and recommendations

• Published in: Virchows Archiv : an international journal of pathology Vol. 473; no. 4; pp. 405 - 412
• Main Authors: van Pelt, G. W., Kjær-Frifeldt, S., van Krieken, J. H. J. M., Al Dieri, R., Morreau, H., Tollenaar, R. A. E. M., Sørensen, F. B., Mesker, W. E.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2018; Springer Nature B.V
• Subjects: Cancer; Colon; Colon cancer; Colorectal cancer; Estimation; International studies; Medicine; Medicine & Public Health; Original; Original Article; Pathology; Stroma; Tumors; Recommendations; Scoring; Colon cancer; Protocol; Tumor-stroma ratio
• ISSN: 0945-6317; 1432-2307; 1432-2307
• DOI: 10.1007/s00428-018-2408-z

The tumor-stroma ratio (TSR) has been reported as a strong, independent prognostic parameter in colon cancer as well as in other epithelial cancer types, and may be implemented to routine pathology diagnostics. The TSR is an easy technique, based on routine hematoxylin and eosin stained histological sections, estimating the amount of stroma present in the primary tumor. It links tumors with high stromal content to poor prognosis. The analysis time is less than 2 min with a low inter-observer variation. Scoring of the TSR has been validated in a number of independent international studies. In this manuscript, we provide a detailed technical description of estimating the TSR in colon cancer, including examples, pitfalls, and recommendations.