Prognostic value of tumor-stroma ratio in early stage cervical adenocarcinoma

Abstract

Background Tumor-stroma ratio (TSR) represents a percentage of neoplastic component to the combined neoplastic and tumor-associated stromal area. TSR has been demonstrated to be a new prognostic factor in cancers of several organs including the uterine cervix. In cervical cancer, TSR was evaluated in only one previous series of carcinoma with mixed histologic types. This study was aimed to assess the prognostic value of TSR in early-stage cervical cancer patients with adenocarcinoma histology only. Methods Histologic slides of patients with early stage (IB-IIA) cervical adenocarcinoma who underwent surgical treatment between January 2003 and December 2011 were reviewed. TSR was categorized as low ( 50%: stroma-poor). The clinical and pathological variables were correlated with the follow-up outcomes. Results Of 131 patients, 38 (29.0%) had low TSR and 93 (71.0%) had high TSR. Cases with low TSR had significantly higher rates of infiltrative border ( p p = 0.011), and parametrial involvement ( p = 0.026). Low TSR was associated with decreased overall survival in the univariate analysis ( p = 0.041), but not in the multivariate analysis. TSR was not associated with tumor recurrence or decreased disease-free survival. Conclusions TSR is not an independent prognostic predictor in surgically-treated early-stage cervical adenocarcinoma patients.