Table 1 Studies evaluating the reactive stroma as a biomarker in prostate cancer.
From: “Stromal cells in prostate cancer pathobiology: friends or foes?”
Author (year) | Main findings |
|---|---|
Ayala et al., (2003; ref. 29.) | ⁃ Development of the reactive stroma grading (RSG) system: ▫ RSG 0: tumours with 0–5% stroma ▫ RSG 1: tumours with 5–15% stroma ▫ RSG 2: tumours with 15–50% stroma ▫ RSG 3: tumours with >50% stroma ⁃ Evaluation of TMA cores by Masson’s trichrome stain from 545 patients ⁃ Volume of reactive stroma was a significant predictor of biochemical disease-free survival ⁃ Worst survival in patients with RSG 0 or RSG 3 |
Yanagisawa et al., (2007; ref. 68.) | ⁃ RSG evaluated using H&E–stained sections of prostate biopsies from 224 patients ⁃ Patients with RSG 1 and 2 had better survival than those with RSG 0 and 3 ⁃ RSG was an independent predictor of recurrence ⁃ RSG is independent of Gleason 7 (either 4 + 3 or 3 + 4) |
Ayala et al., (2011; ref. 65.) | ⁃ Evaluation of the predictive value of the %RGS 3 in the entire tumour ⁃ 872 whole-mount, H&E–stained prostatectomy specimens ⁃ %RSG 3 was an independent predictor of biochemical recurrence ⁃ Higher %RSG 3 patients had a significantly decreased biochemical recurrence-free survival than those with lower %RSG 3 |
Billis et al., (2013; ref. 66.) | ⁃ 266 H&E–stained needle prostatic biopsies ⁃ Increasing RSG was associated with higher clinical stage, preoperative PSA, Gleason score, and with more extensive tumours in radical prostatectomies ⁃ Only RSG 3 was associated with biochemical recurrence, but only on univariate analysis |
Wu et al., (2014; ref. 67.) | ⁃ 148 biopsies from patients with advanced PCa (cT3-cT4) before castration therapy, evaluated by Masson’s trichrome ⁃ RSG was inversely correlated with Gleason scores ⁃ Significant association between RSG and development of castration-resistant PCa in patients with initial Gleason score of 6–7 |
Saeter et al., (2015; ref. 64.) | ⁃ Population-based study using H&E biopsies from 318 patients ⁃ RSG was associated with PCa-specific mortality in multivariate Cox regression analysis |
McKenney et al., (2016; ref. 70.) | ⁃ TMA cores from 1275 radical prostatectomies (Canary Retrospective Cohort) evaluated by H&E ⁃ Among the multiple architectural features assessed, cores were evaluated for presence/absence of RSG 3 ⁃ RSG 3 was associated with decreased post-surgery recurrence-free survival ⁃ RSG 3 was associated with worse survival when Gleason score 3 + 4 = 7 carcinomas alone were considered |
Saeter et al., (2016; ref. 62.) | ⁃ Population-based study using H&E biopsies from 318 patients ⁃ Perineural invasion (PNI) was associated with high RSG ⁃ The prognostic effect of PNI is dependent on an association with reactive stroma |
Saeter et al., (2016; ref. 63.) | ⁃ Population-based study using H&E biopsies from 283 patients ⁃ Patients with concomitant lymphovascular invasion (LVI) and high RSG were at high risk for PCa-specific death. |
Ruder et al., (2022; ref. 69.) | ⁃ Refinement of the original 4-tiers RSG to a binary system (qRS): ▫ qRS negative: tumours with <34% reactive stroma ▫ qRS positive: tumours with >34% reactive stroma ⁃ Algorithm-based quantification of reactive stroma ⁃ TMA cores from biopies and radical prostatectomies from different cohorts evaluated by H&E; > 1000 patients in total ⁃ qRS >34% was associated with worse outcomes (biochemical recurrence or PCa-specific death), after correcting for Gleason score and PSA |
