Correlation between tumor stroma ratio, prognosis, and apparent diffusion coefficient in alveolar soft part sarcoma

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• The prognostic value of tumor stroma ratio (TSR) in alveolar soft part sarcoma (ASPS) is not well-established.
• Limited non-invasive imaging biomarkers are available for assessing TSR in ASPS.

Purpose of the Study:

• To investigate the correlation between tumor stroma ratio (TSR) and survival outcomes in patients with ASPS.
• To evaluate the utility of apparent diffusion coefficient (ADC) histogram parameters in assessing TSR in ASPS.

Main Methods:

• Retrospective analysis of 61 ASPS patients.
• TSR classification based on histology (stroma-rich vs. stroma-poor).
• Correlation analysis with clinicopathological characteristics and survival (5-year progression-free survival [5-PFS] and 5-year overall survival [5-OS]) using Kaplan-Meier, log-rank, and Cox regression.
• Assessment of ADC histogram parameters and their correlation with TSR using t-tests/Mann-Whitney U and ROC curve analysis.

Main Results:

• Low TSR was significantly associated with lymph node metastasis (p=0.048).
• Low TSR independently predicted poorer 5-PFS (HR=10.456, p=0.009) and 5-OS (HR=4.789, p=0.030).
• ADC histogram parameters (ADC25th, ADC50th, ADCmean) differed significantly between TSR groups (p<0.05).
• Combined ADC values demonstrated improved diagnostic efficiency for TSR assessment (AUC=0.781).

Conclusions:

• TSR is an independent prognostic factor for progression-free and overall survival in ASPS.
• ADC histogram parameters serve as valuable non-invasive imaging biomarkers for evaluating TSR in ASPS.
• This approach may aid in predicting ASPS progression.