Stroma AReactive Invasion Front Areas (SARIFA): a Novel Histopathologic Biomarker in Colorectal Cancer Patients and Its Association with the Luminal Tumour Proportion

Overview

Journal Transl Oncol

Specialty Oncology

Date 2024 Apr 9

PMID 38593584

Authors

N G Reitsam

B Grosser

J S Enke

W Mueller

A Westwood

N P West

P Quirke

B Markl

H I Grabsch

Affiliations

Soon will be listed here.

Abstract

Background: Stroma AReactive Invasion Front Areas (SARIFA) is a novel prognostic histopathologic biomarker measured at the invasive front in haematoxylin & eosin (H&E) stained colon and gastric cancer resection specimens. The aim of the current study was to validate the prognostic relevance of SARIFA-status in colorectal cancer (CRC) patients and investigate its association with the luminal proportion of tumour (PoT).

Methods: We established the SARIFA-status in 164 CRC resection specimens. The relationship between SARIFA-status, clinicopathological characteristics, recurrence-free survival (RFS), cancer-specific survival (CSS), and PoT was investigated.

Results: SARIFA-status was positive in 22.6% of all CRCs. SARIFA-positivity was related to higher pT, pN, pTNM stage and high grade of differentiation. SARIFA-positivity was associated with shorter RFS independent of known prognostic factors analysing all CRCs (RFS: hazard ratio (HR) 2.6, p = 0.032, CSS: HR 2.4, p = 0.05) and shorter RFS and CSS analysing only rectal cancers. SARIFA-positivity, which was measured at the invasive front, was associated with PoT-low (p = 0.009), e.g., higher stroma content, and lower vessel density (p = 0.0059) measured at the luminal tumour surface.

Conclusion: Here, we validated the relationship between SARIFA-status and prognosis in CRC patients and provided first evidence for a potential prognostic relevance in the subgroup of rectal cancer patients. Interestingly, CRCs with different SARIFA-status also showed histological differences measurable at the luminal tumour surface. Further studies to better understand the relationship between high luminal intratumoural stroma content and absence of a stroma reaction at the invasive front (SARIFA-positivity) are warranted and may inform future treatment decisions in CRC patients.

Citing Articles

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PMID: 39365350 DOI: 10.1007/s00292-024-01368-9.

Converging deep learning and human-observed tumor-adipocyte interaction as a biomarker in colorectal cancer.

Reitsam N, Grosser B, Steiner D, Grozdanov V, Wulczyn E, LImperio V Commun Med (Lond). 2024; 4(1):163.

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The SARIFA biomarker in the context of basic research of lipid-driven cancers.

Markl B, Reitsam N, Grochowski P, Waidhauser J, Grosser B NPJ Precis Oncol. 2024; 8(1):165.

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The relationship between Stroma AReactive Invasion Front Areas (SARIFA), Warburg-subtype and survival: results from a large prospective series of colorectal cancer patients.

Offermans K, Reitsam N, Simons C, Grosser B, Zimmermann J, Grabsch H Cancer Metab. 2024; 12(1):21.

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Artificial Intelligence in Colorectal Cancer: From Patient Screening over Tailoring Treatment Decisions to Identification of Novel Biomarkers.

Reitsam N, Enke J, Vu Trung K, Markl B, Kather J Digestion. 2024; 105(5):331-344.

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