Prognostic significance of tumour–stroma ratio in prostatic adenocarcinoma: An analysis of radical prostatectomy specimens

Background: Prostate cancer (PCa) represents the second most- frequently diagnosed malignancy and fifth leading cause of cancer death in men. Gleason grade group, pathological stage and surgical margins are independent predictors of recurrence after radical prostatectomy (RP). In recent years, tumor -stroma ratio (TSR) has been reported as a prognostic factor. There are very few studies on the prognostic significance of TSR in PCa. Aims and Objectives: The objectives of the study were to assess TSR in RP specimens for PCa and to correlate TSR with known prognostic factors, Capra S score and time to biochemical recurrence (BR) if any. Materials and Methods: A retrospective study of 143 biopsy- proven PCa cases who underwent RP at our centre from January 2017 - August 2022 was conducted. TSR was scored independently by two pathologists and statistically correlated with known prognostic factors, Capra S score and time to BR. Multivariate analysis of prognostic factors was done using Kendall Tau rank correlation and time to BR was plotted on Kaplan Meier plot. Results: TSRs ranged from 0.1 to 1.5 and were stratified to arrive at cut-off values that significantly correlated with CAPRA S score and time to BR. Higher TSR was associated with longer survival in our study. Conclusion: TSR quantification will help in identifying patients at high risk of progression.