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INTRODUCTION: Patients with a high stroma percentage within the primary tumor have a poor prognosis. In this study, we investigate whether anti-angiogenic therapy might improve survival of patients with a stroma-high profile with potentially increased angiogenesis. MATERIALS AND METHODS: Tissue samples of the primary tumor of 965 colon cancer patients participating in the QUASAR2 trial were analyzed for tumor-stroma ratio (TSR). Stroma-high (>50%) and stroma-low (≤50%) groups were evaluated with respect to survival. RESULTS: Disease free survival (DFS) was significantly lower in the stroma-high group (HR 1.53, 95%CI 1.19-1.95, P = 0.001). No difference in DFS was seen with respect to treatment with capecitabine alone (CAP) or capecitabine with bevacizumab (CAPBEV) (Stroma-high HR 1.00, 95%CI 0.69-1.46, P = 0.996; stroma-low HR 1.02, 95%CI 0.75-1.41, P = 0.883). A significant difference in survival was seen comparing groups with or without vascular invasion (DFS P 

Original publication




Journal article


J Surg Oncol

Publication Date





1043 - 1048


personalized therapy, prognosis, tumor microenvironment, tumor-stroma ratio, vascular invasion, Aged, Antineoplastic Combined Chemotherapy Protocols, Bevacizumab, Capecitabine, Cohort Studies, Colonic Neoplasms, Female, Follow-Up Studies, Humans, Male, Neoplasm Invasiveness, Prognosis, Risk Factors, Stromal Cells, Survival Rate