Work

A Histology‐Derived Score Integrating Tumor–Stroma Ratio, Tertiary Lymphoid Structures, and Tumor Budding Improves Prognostic Stratification in Colorectal Cancer

Year: 2026

Type: article

Abstract: OBJECTIVE: To evaluate a histology-derived score (HDS) integrating tumor-stroma ratio (TSR), tertiary lymphoid structures (TLS), and tumor budding (TB) for prognostic stratification in colorectal cancer (CRC) and assess its incremental prognostic value. METHODS: A total of 559 patients with CRC were retrospectively enrolled and randomly split 7:3 into a training cohort (n = 392) and an internal validation cohort (n = 167). TSR, TLS, and TB were assessed on hematoxylin and eosin (H&E)-stained sections to construct the HDS, with predefined low- (3-4), intermediate- (5-6), and high-risk (7-8) groups. Independent prognostic factors were identified using multivariable Cox regression and incorporated into a nomogram. The incremental prognostic value of HDS was assessed by comparing nested models using the concordance index (C-index), likelihood-ratio test (LRT), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). RESULTS: : HR = 3.10, 95% CI: 1.75-5.47, p < 0.001), TNM stage (III vs. I: HR = 3.26, 95% CI: 1.49-7.12, p < 0.001), and lymphovascular invasion (LVI) (yes vs. no: HR = 1.70, 95% CI: 1.09-2.64, p = 0.020) as independent prognostic factors for disease-free survival (DFS). Adding HDS to TNM + LVI increased the C-index from 0.709 to 0.738 in the training cohort (LRT, p < 0.001; NRI = 0.454, p = 0.012; IDI = 0.050, p < 0.001) and from 0.655 to 0.669 in the internal validation cohort (LRT, p = 0.033; NRI = 0.313, p = 0.148; IDI = 0.029, p = 0.044). The nomogram showed good discrimination, calibration, and clinical utility in both cohorts. CONCLUSIONS: HDS provided incremental prognostic information beyond TNM stage and LVI in CRC. The HDS-based nomogram may facilitate individualized prognostic assessment, although external multicenter validation is required.

Source: Cancer Medicine

DOI: 10.1002/cam4.72495

Authors: Meng Tian, Jianwei Yuan, Quanquan Hu, Lanlan Xuan

Institutions: China Pharmaceutical University, Bengbu Medical College, Anqing City Hospital

Language: English

Topic: Colorectal Cancer Surgical Treatments

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,700