Oncology Reviews最新文献

{"title":"Temporal changes in tongue color during immune checkpoint inhibitor therapy in patients with non-small-cell lung cancer: a prospective observational study using digital tongue diagnosis.","authors":"Eunbyul Cho, Woosu Choi, Jun Hyeok Lim, Ji Woong Son, Seung Hun Jang, Seung Hyeun Lee, Jong Gwon Choi, In-Jae Oh, Tae-Won Jang, Seong Hoon Yoon, Seung Joon Kim, Chang-Min Choi, Sung Yong Lee, Mi Mi Ko, Mi-Kyung Jeong","doi":"10.3389/or.2025.1697252","DOIUrl":"10.3389/or.2025.1697252","url":null,"abstract":"<p><strong>Background: </strong>Tongue diagnosis (TD), a key component of traditional East Asian medicine, employs a unique pattern-based diagnostic system. Digital TD enables quantitative assessment of tongue characteristics, like body and coating color, enhancing objectivity and reproducibility. While abnormal tongue features (including dark red, bluish, or pale appearance) have been documented in patients with cancer, the relationship between longitudinal changes in tongue characteristics and immune checkpoint inhibitor (ICI) treatment response or survival outcomes in non-small-cell lung cancer (NSCLC) remains underexplored. This multicenter, prospective, observational study investigated whether longitudinal tongue changes differ by ICI response and predict survival in patients with NSCLC.</p><p><strong>Methods: </strong>We enrolled patients with stage IIIB, IIIC, or IV NSCLC scheduled to receive second-line or subsequent pembrolizumab or atezolizumab following first-line platinum-based therapy failure. Digital tongue images were collected every 9 weeks from baseline to week 45. Linear mixed models evaluated temporal parameter changes and compared responders (durable clinical benefits ≥6 months) <i>versus</i> nonresponders. Multivariate Cox models adjusted for sex and age assessed tongue lightness changes as a prognostic value for progression-free survival (PFS) and overall survival (OS). Survival distributions were compared using Kaplan-Meier curves.</p><p><strong>Results: </strong>Of 170 enrolled participants, 140 were included in the analysis. Early in treatment, tongue lightness decreased in the body, fur, root, and center areas in both responders and nonresponders; however, the darkening was more pronounced in nonresponders, with significant visit-by-response interaction effects. In multivariate Cox analysis, lightness changes of the tongue body were significantly associated with PFS (hazard ratio [HR] = 0.93; 95% confidence interval [CI], 0.88-0.99; <i>p</i> = 0.019) and showed a trend for OS (HR = 0.93; 95% CI, 0.86-1.00; <i>p</i> = 0.062). Lightness changes of the tongue center were also significantly associated with PFS (HR = 0.95; 95% CI, 0.90-0.99; <i>p</i> = 0.027). Kaplan-Meier analysis confirmed that patients with a greater decrease in tongue body lightness had significantly shorter OS (<i>p</i> = 0.049).</p><p><strong>Conclusion: </strong>Digital TD diagnosis, particularly monitoring tongue lightness changes, may provide a valuable noninvasive prognostic tool for patients with NSCLC undergoing ICI therapy. It offers information for both PFS and OS, potentially complementing current biomarkers for cancer immunotherapy.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1697252"},"PeriodicalIF":5.2,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12722973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DNA methylation as prognostic factors in non-muscle-invasive bladder cancer: a systematic review and meta-analysis.","authors":"Vishwajeet Singh, Mukul Kumar Singh, Anil Kumar, Ashutosh Shrivastava, Dinesh Kumar Sahu, Mayank Jain, Anuj Kumar Pandey","doi":"10.3389/or.2025.1679974","DOIUrl":"10.3389/or.2025.1679974","url":null,"abstract":"<p><strong>Introduction: </strong>Early prognostication in non-muscle-invasive bladder cancer (NMIBC) is essential for optimizing therapy and follow-up. Epigenetic mechanisms, particularly DNA methylation, have emerged as promising biomarkers for predicting disease outcome.</p><p><strong>Materials and methods: </strong>A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate the prognostic significance of promoter DNA methylation in NMIBC. Comprehensive searches of PubMed, Web of Science, Embase, MEDLINE, and the Cochrane Library (January 2010-October 2022) identified eligible studies. The Newcastle-Ottawa scale was used for quality assessment, and pooled hazard ratios with 95% confidence intervals were calculated using random-effects models.</p><p><strong>Results: </strong>Eleven studies with 3,065 NMIBC patients were analyzed. Promoter methylation was significantly associated with poor progression-free survival (pooled hazard ratios (HR) = 2.88; 95% CI = 2.03-4.09; p < 0.0001) and recurrence-free survival (pooled HR = 2.65; 95% CI = 1.93-3.63; p < 0.0001). Although overall survival showed pathway-specific variation (pooled HR = 0.96; 95% CI = 0.36-2.60; p = 0.94), methylation of adhesion and apoptosis-related genes exhibited the strongest associations. Subgroup analyses revealed a greater prognostic impact in Asian cohorts (p < 0.0001), suggesting regional differences in epigenetic susceptibility.</p><p><strong>Conclusion: </strong>Promoter DNA methylation constitutes a robust prognostic biomarker for recurrence and progression in NMIBC, with stronger effects in Asian populations. Standardization of validated gene panels, assay thresholds, and cross-regional prospective validation will be essential for clinical translation. Integrating methylation-based classifiers into risk stratification models could improve individualized management and long-term outcomes in NMIBC.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1679974"},"PeriodicalIF":5.2,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural recurrence in well-differentiated papillary thyroid carcinoma: a 10-year single center cohort study.","authors":"Francisco Araújo Dias, Rafael Pereira de Souza, Tabata Briaunys Milan, Rafael De Cicco","doi":"10.3389/or.2025.1638499","DOIUrl":"10.3389/or.2025.1638499","url":null,"abstract":"<p><strong>Introduction: </strong>Well-differentiated papillary thyroid carcinoma (PTC) generally carries an excellent prognosis; however, certain pathological features such as gross extrathyroidal extension and tumor diameter ≥2 cm have been associated with structural disease recurrence. This study aimed to identify the key clinical and histopathological factors associated with disease-free survival in patients undergoing total thyroidectomy for PTC.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted including 750 patients who underwent total thyroidectomy with or without neck dissection between 2014 and 2024 at a tertiary academic cancer center. Clinical, pathological, and oncological follow-up data were analyzed over a maximum follow-up period of 100 months. Kaplan-Meier survival analysis, log-rank testing, and Cox proportional hazards regression were employed for statistical evaluation.</p><p><strong>Results: </strong>The structural recurrence rate was 4%, and overall survival reached 99%. In the multivariate analysis, only gross extrathyroidal extension (HR 3.29; p = 0.008) and tumor diameter (HR 1.32; p = 0.013) were independently associated with recurrence. Variables such as age, smoking status, perineural invasion, vascular invasion, and central lymph node involvement did not show significant associations with structural recurrence.</p><p><strong>Conclusion: </strong>Gross extrathyroidal extension and increased tumor diameter were identified as the primary prognostic factors for structural recurrence in patients with PTC. Multicenter studies are warranted to validate these findings in the broader Brazilian population.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1638499"},"PeriodicalIF":5.2,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12675403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone marrow mesenchymal stem cells and adipocytes in haematological malignancies.","authors":"Blanca Gonzalez-Garcia, Cristina Aparicio, Rocio Abia, Francisco J G Muriana, Sara M Jaramillo-Carmona","doi":"10.3389/or.2025.1704345","DOIUrl":"10.3389/or.2025.1704345","url":null,"abstract":"","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1704345"},"PeriodicalIF":5.2,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12675329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotype-phenotype correlations in <i>PMS2</i>-associated constitutional mismatch repair deficiency: a systematic literature review.","authors":"Cătălin Vasile Munteanu, Diana Luisa Lighezan, Alexandru Capcelea, Adela Chiriță-Emandi, Adrian Pavel Trifa","doi":"10.3389/or.2025.1679576","DOIUrl":"10.3389/or.2025.1679576","url":null,"abstract":"<p><p>Constitutional mismatch repair deficiency (CMMRD) is a rare pediatric cancer predisposition syndrome primarily characterised by central nervous system (CNS), gastro-intestinal (GI) tumours and hematological malignancies, along with NF1-like cutaneous features. The <i>PMS2</i>-related subtype (<i>PMS2</i>-CMMRD) is the most common molecular form of CMMRD, exhibiting variable severity and both early and late-onset clinical presentations. Although pathogenic and likely pathogenic <i>PMS2</i> heterozygous variants are relatively frequent in healthy population, CMMRD incidence is generally rare in humans and genotype-phenotype correlations are still limited. To better characterise <i>PMS2</i>-CMMRD group, we collected clinical cases described in literature, using three alternative methods (VarChat, VarSome and LitVar2), starting from 102 pathogenic/likely pathogenic <i>PMS2</i> variants (<50 bp) reported in ClinVar by clinical and research laboratories. <i>PMS2</i>-CMMRD cases were split into two distinct groups based on tumour onset age: early (diagnosis under 10 years) and later-onset (diagnosis after 10 years). Significant differences in tumour distribution were observed, with CNS tumours being most prevalent in the early-onset group, while GI tumours were more common in the later-onset group. Six <i>PMS2</i> variants were associated with either early or later-onset CMMRD. Future validation through larger prospective cohort studies is necessary to confirm our findings and better understand the natural history of <i>PMS2</i>-CMMRD to inform clinical decision-making in <i>PMS2</i>-Lynch syndrome (<i>PMS2</i>-LS).</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1679576"},"PeriodicalIF":5.2,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic regulation of RNA methylations in gastric cancer.","authors":"Kaijie Liu, Yafeng Liu, Shujun Zhang, Ziang Li, Wenbing Qu, Penghui Li, Xinjun Hu","doi":"10.3389/or.2025.1601511","DOIUrl":"https://doi.org/10.3389/or.2025.1601511","url":null,"abstract":"<p><p>Gastric cancer (GC) remains a major global health challenge due to its high incidence and mortality. Emerging evidence underscores the critical role of RNA methylation, a key layer of epigenetic regulation, in GC pathogenesis. This review synthesizes current knowledge on various RNA modifications, including m⁶A, m⁵C, m¹A, and m⁷G, in GC. We critically evaluate the functions of their regulatory proteins (writers, erasers, readers) in modulating oncogenic signaling, metastasis, and tumor immunity. Among these, m⁶A and m⁵C modifications currently present the most compelling evidence, demonstrating significant correlations with patient prognosis and therapy resistance. Furthermore, we explore the translational potential of targeting the RNA methylation machinery, discussing both promising avenues and existing challenges in drug development. This comprehensive analysis aims to provide deeper mechanistic insights and highlight novel therapeutic opportunities for GC.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1601511"},"PeriodicalIF":5.2,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12647115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research on the application of a multi-model cascaded deep learning framework in the pathological diagnosis of osteosarcoma.","authors":"Hui Yao, Mengxue Yang, Xin Jiang, Hao Jia, Tao Sun, Molin Li, Taiping Wang, Xuefeng Tang","doi":"10.3389/or.2025.1592408","DOIUrl":"https://doi.org/10.3389/or.2025.1592408","url":null,"abstract":"<p><strong>Introduction: </strong>Osteosarcoma is the most common malignant tumor of bone tissue in adolescents, and precise pathological diagnosis is the primary foundation for establishing the most effective treatment plan. The pathological evaluation of tumor necrosis after chemotherapy is crucial for assessing therapeutic efficacy in osteosarcoma patients. However, pathologists often face several challenges during the diagnosis and evaluation process.</p><p><strong>Methods: </strong>To address these needs, we designed and developed a multi-model cascaded deep learning framework utilizing an advanced Vision Mamba (ViM) model as the core network architecture. The study employed one of the most comprehensive osteosarcoma datasets, sourced from: (1) real-world data from 68 osteosarcoma patients collected at Chongqing General Hospital, and (2) publicly available osteosarcoma assessment data from the University of Texas Southwestern/UT Dallas. Pathological images were annotated using the Palgo pathology image artificial intelligence self-training platform according to algorithm requirements. A triple verification mechanism of annotation, review, and archiving was implemented, and Palgo's integrated interactive algorithm correction mechanism was used to continuously refine the data annotation process.</p><p><strong>Results and discussion: </strong>The model demonstrated Dice coefficient values of 0.83 or higher in tumor segmentation, osteosarcoma osteoid matrix segmentation, necrotic area segmentation, lung metastatic tumor segmentation, and lung metastatic osteoid matrix segmentation. For necrosis classification, overall osteosarcoma subtypes, and localized osteosarcoma subtypes, the area under the receiver operating characteristics curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) all exceeded 90%. The proposed model exhibited excellent performance, indicating high potential for future clinical application in osteosarcoma patients. This framework shows promise for enhancing the precision and efficiency of pathological diagnosis and evaluation in osteosarcoma management.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1592408"},"PeriodicalIF":5.2,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of thulium laser <i>en bloc</i> resection of bladder tumor and transurethral resection of bladder tumor on catheter-related bladder discomfort- a single center experience.","authors":"Wenbo Gao, Haihon Ye, Jiawen Huang, Telei Chen","doi":"10.3389/or.2025.1653825","DOIUrl":"https://doi.org/10.3389/or.2025.1653825","url":null,"abstract":"<p><strong>Objective: </strong>To Compare the effects between thulium laser <i>en bloc</i> resection of bladder tumor (ERBT) and conventional transurethral resection of bladder tumor (TURBT) on catheter-related bladder discomfort (CRBD) in patients with bladder cancer.</p><p><strong>Methods: </strong>Between January 2022 and December 2024, we retrospectively collected the demographic and clinical data for patients with bladder cancer. A total of 79 patients in the conventional TURBT group and 58 patients in the thulium laser ERBT group completed the study. Both demographic and outcome variables were recorded; and we compared the incidence and severity of CRBD at 1, 6 and 24 h postoperatively, score of postoperative pain at 1, 6 and 24 h and patient satisfaction at 24 h following the surgery.</p><p><strong>Results: </strong>There were no significant differences in age, gender proportion, tumor multiplicity, tumor size and location, and duration of surgery between the two groups (<i>P ></i> 0.05). Pathological examination revealed that the ERBT had a higher rate of detrusor presence than TURBT (<i>P</i> = 0.04). The incidence and severity of postoperative CRBD were lower in ERBT group than TURBT group at 1 and 6h (<i>P</i> < 0.001), while there were no statistically significant difference between the two groups (<i>P</i> = 0.17) at 24 h. The VAS scores of postoperative pain were significantly lower in ERBT group than in TURBT group at 1 and 6 h postoperatively (<i>P</i> = 0.001 and <i>P</i> = 0.02, respectively). But at 24 h, there was no statistically significant difference (<i>P</i> = 0.08). As to postoperative patient satisfaction at 24 h, the result of ERBT group was significantly lower than TURBT group (<i>P</i> = 0.02). Additionally, the ERBT group had significantly less intraoperative blood loss and shorter postoperative irrigation duration (<i>P</i> = 0.001). No significant difference was found in the duration of indwelling catheter between the two groups (<i>P</i> = 0.07).</p><p><strong>Conclusion: </strong>The results suggest that compared to conventional TURBT, thulium laser ERBT significantly reduce CRBD incidence and severity, lower postoperative pain, and improve postoperative patient satisfaction. However, as a single-center retrospective study, these findings require further validation by large-scale, prospective, multicenter trials.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1653825"},"PeriodicalIF":5.2,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting the opposing regulatory functions of endogenous nitric oxide production in colorectal cancer initiation, adaptive immune response alterations, and ferroptosis execution.","authors":"Amol Tatode, Anis Ahmad Chaudhary, Mohammad Qutub, Rashmi Trivedi, Milind Umekar, Mohamed A M Ali, Tanvi Premchandani","doi":"10.3389/or.2025.1671235","DOIUrl":"10.3389/or.2025.1671235","url":null,"abstract":"<p><p>Colorectal cancer (CRC) progresses through defined stages, from localized carcinoma <i>in situ</i> (Stage 0) to metastatic disease (Stage IV), with treatment strategies evolving from surgery in early stages to systemic therapies in advanced stages. Advances in biomarkers and genomic profiling have enabled personalized approaches, enhancing precision medicine. Nitric oxide (NO) plays a multifaceted role in CRC, acting as both a promoter and an inhibitor of cancer progression depending on its concentration, timing, and cellular context. At low concentrations, NO promotes angiogenesis, enabling tumor growth and metastasis. Conversely, high concentrations can exert anti-tumor effects, including the induction of cell death. Notably, its role in ferroptosis is biphasic: while high, exogenously delivered concentrations of NO can induce this iron-dependent cell death, lower, endogenously regulated levels can be protective by terminating lipid peroxidation. NO influences CRC by modulating the tumor microenvironment, mechanostress responses during metastasis, and signaling through extracellular vesicles (EVs), thereby aiding immune evasion. It also reprograms CRC cell metabolism, enhancing glucose utilization and mitochondrial activity to support growth in hypoxic conditions. The three nitric oxide synthases (NOS)-inducible NOS (iNOS), endothelial NOS (eNOS), and neuronal NOS (nNOS)-interact with hydrogen sulfide (H₂S) to regulate oxidative stress and tumor growth. Targeting NO-related processes, such as ferroptosis, metabolic adaptations, and immune modulation, offers promising therapeutic advances to improve CRC treatment outcomes. This review highlights the dual role of NO in CRC, with particular focus on its novel mechanisms in ferroptosis, metabolism, immune modulation, and tumor-microenvironment interactions.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1671235"},"PeriodicalIF":5.2,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12627049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of TSR analysis in colorectal cancer: implications for automated solutions.","authors":"Felix Anne Dikland, Cyrine Fekih, Marius René Jacques Wellenstein, Ricella Souza da Silva, Raquel Machado-Neves, João Fraga, Domingos Oliveira, Diana Montezuma, Isabel Macedo Pinto, Jonathan Woodburn","doi":"10.3389/or.2025.1605383","DOIUrl":"10.3389/or.2025.1605383","url":null,"abstract":"<p><p>The tumour-stroma ratio (TSR), which refers to the composition of stromal tissue and tumour epithelium of a malignant lesion, is gaining recognition as a promising biomarker in pathology. In 2018, recommendations for quantifying TSR in colorectal carcinoma were published, yet diverse quantification methods are still in use today. To assess the prognostic value of TSR, evaluate the impact of scoring variations, and explore efforts to automate TSR quantification, a scoping review was conducted. A total of 950 articles were identified through PubMed and Scopus, of which 76 met the inclusion criteria for this review. Of these, 56 employed manual scoring methods, while 20 utilised semi-automated or fully automated TSR quantification techniques. The TSR has been consistently identified as a strong prognostic indicator for disease-free survival. Its association with poor prognosis may be linked to its correlation with metastatic status, perineural invasion, and vascular invasion in stroma-high lesions. Variability in TSR scoring protocols was most evident in the selection of the region of interest and the type of histological specimen, both of which had a direct impact on final TSR scores. Moreover, significant inter-observer variability was observed in manual semi-quantitative TSR assessments, with Kappa scores ranging from 0.42 to 0.88. Automated TSR scoring pipelines have been proposed to standardise scoring protocols and reduce inter-observer variability. Deep learning models have demonstrated promising results, with pixel-wise and patch-wise accuracies exceeding 95%. Even though deep learning approaches have shown high performance, discrepancies remain, as evidenced by Kappa scores ranging from 0.239 to 0.472. In conclusion, the variation in TSR scoring protocols, along with a wide range of inter-observer variability, limits the broader clinical application of TSR. While automated TSR quantification methods show promise, they are still in the early stages, particularly in relation to region of interest selection and stratifying patients into risk categories. As these methods evolve, adjustments to TSR scoring cut-off values may be necessary to improve consistency. This scoping review highlights the prognostic significance of TSR in colorectal carcinoma while emphasizing the challenges posed by variability in scoring methods and the need for further advancements in automated quantification.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"19 ","pages":"1605383"},"PeriodicalIF":5.2,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12603809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}