Exploring prognostic and predictive application of the tumor-stroma ratio in colorectal cancer

Zunder, S.M. (2021)

Doctoral Thesis

There is a pending need for prognostic and predictive biomarkers in the treatment of patients with colorectal cancer.
This thesis describes the prognostic and predictive application of the tumor-stroma ratio (TSR) in colorectal cancer, focusing on expanding current clinical-pathological standards and combining TSR with other diagnostic parameters. The TSR is a microscopy scoring method performed on hematoxylin-eosin stained tissue slides used for routine pathology assessment, and has proven to be a robust prognostic maker. Here, we investigate whether the TSR also exhibits predictive value with regard to adjuvant targeted therapy in stage II and III colon cancer. Moreover, exploring the value of collagen fiber organization in the intratumoral stroma, as well as combining this parameter with the TSR. Finally, expanding the application of the TSR with radiological diagnostics in rectal cancer. Assessing is there is a correlation between TSR and apparent diffusion coefficient values obtained from diagnostically performed MRI-DWI scans, in order to determine if there is potential with regards to neoadjuvant treatment choices or patient follow-up.

• Tumor-stroma
• Colorectal cancer
• Tumor microenvironment
• Prognosis
• Prediction

• All authors: Zunder, S.M.
• Supervisor: Gelderblom, A.J.; Tollenaar, R.A.E.M.
• Co-supervisor: Mesker, W.E.
• Committee: Portielje, J.E.A.; Beets, G.L.; Krieken, J.H.J.M. van
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center [LUMC], Leiden University
• Date: 2021-04-15
• ISBN (print): 9789464162073