{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:07:18Z","timestamp":1790802438133,"version":"4.1.0"},"reference-count":44,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004329","name":"The Slovenian Research and Innovation Agency","doi-asserted-by":"publisher","award":["P3-0036"],"award-info":[{"award-number":["P3-0036"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"The Slovenian Research and Innovation Agency","doi-asserted-by":"publisher","award":["N1-0305"],"award-info":[{"award-number":["N1-0305"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020027","name":"Dr Rolf M Schwiete Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["P500PM_217647\/1"],"award-info":[{"award-number":["P500PM_217647\/1"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","ejcancer.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Cancer"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.ejca.2026.117035","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:38:57Z","timestamp":1789054737000},"page":"117035","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Direct Tumor-Adipocyte Contact as a Prognostic Biomarker in Resected Pancreatic Ductal Adenocarcinoma"],"prefix":"10.1016","volume":"247","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5091-5060","authenticated-orcid":false,"given":"Michael","family":"G\u00fcnther","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3966-3579","authenticated-orcid":false,"given":"Konstantin","family":"Br\u00e4utigam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5378-3825","authenticated-orcid":false,"given":"Martin","family":"Wartenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed D.","family":"Arslan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Sucher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7228-5197","authenticated-orcid":false,"given":"Mohamed","family":"El-Mahrouk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9200-441X","authenticated-orcid":false,"given":"Jens","family":"Neumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0145-3696","authenticated-orcid":false,"given":"Przemyslaw","family":"Grochowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna S.","family":"Wenning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2135-605X","authenticated-orcid":false,"given":"Beat","family":"Gloor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berna","family":"Dornieden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Gr\u00fctzmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Pilarsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arndt","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5418-3349","authenticated-orcid":false,"given":"Markus","family":"Eckstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"M\u00e4rkl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8528-8581","authenticated-orcid":false,"given":"Christian","family":"Matek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3027-8164","authenticated-orcid":false,"given":"Kristijan","family":"Skok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0754-9034","authenticated-orcid":false,"given":"Steffen","family":"Ormanns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nic G.","family":"Reitsam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ejca.2026.117035_bib1","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"10.1016\/j.ejca.2026.117035_bib2","doi-asserted-by":"crossref","DOI":"10.1038\/s41568-021-00418-1","article-title":"Pancreatic cancer evolution and heterogeneity: integrating omics and clinical data","volume":"22","author":"Connor","year":"2022","journal-title":"Nat Rev Cancer"},{"key":"10.1016\/j.ejca.2026.117035_bib3","doi-asserted-by":"crossref","DOI":"10.1038\/s41588-024-01914-4","article-title":"Spatial transcriptomic analysis of primary and metastatic pancreatic cancers highlights tumor microenvironmental heterogeneity","volume":"56","author":"Khaliq","year":"2024","journal-title":"Nat Genet"},{"key":"10.1016\/j.ejca.2026.117035_bib4","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1038\/s41698-024-00662-2","article-title":"The SARIFA biomarker in the context of basic research of lipid-driven cancers","volume":"8","author":"M\u00e4rkl","year":"2024","journal-title":"NPJ Precis Oncol"},{"key":"10.1016\/j.ejca.2026.117035_bib5","doi-asserted-by":"crossref","DOI":"10.1038\/s41416-023-02515-4","article-title":"Stroma AReactive Invasion Front Areas (SARIFA) improves prognostic risk stratification of perioperative chemotherapy treated oesophagogastric cancer patients from the MAGIC and the ST03 trial","volume":"130","author":"Grosser","year":"2024","journal-title":"Br J Cancer"},{"key":"10.1016\/j.ejca.2026.117035_bib6","doi-asserted-by":"crossref","DOI":"10.1002\/path.5810","article-title":"Stroma AReactive Invasion Front Areas (SARIFA) \u2013 a new prognostic biomarker in gastric cancer related to tumor-promoting adipocytes","volume":"256","author":"Grosser","year":"2022","journal-title":"J Pathol"},{"key":"10.1016\/j.ejca.2026.117035_bib7","doi-asserted-by":"crossref","DOI":"10.1007\/s10120-023-01436-8","article-title":"Stroma AReactive Invasion Front Areas (SARIFA) proves prognostic relevance in gastric carcinoma and is based on a tumor-adipocyte interaction indicating an altered immune response","volume":"27","author":"Grosser","year":"2024","journal-title":"Gastric Cancer"},{"key":"10.1016\/j.ejca.2026.117035_bib8","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1038\/s41416-025-03034-0","article-title":"Stroma AReactive Invasion Front Areas (SARIFA) and the tumour immune microenvironment in colorectal cancer","volume":"132","author":"Reitsam","year":"2025","journal-title":"Br J Cancer"},{"key":"10.1016\/j.ejca.2026.117035_bib9","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1038\/s41417-023-00695-y","article-title":"Novel biomarker SARIFA in colorectal cancer: highly prognostic, not genetically driven and histologic indicator of a distinct tumor biology","volume":"31","author":"Reitsam","year":"2024","journal-title":"Cancer Gene Ther"},{"key":"10.1016\/j.ejca.2026.117035_bib10","doi-asserted-by":"crossref","DOI":"10.1016\/j.tranon.2024.101913","article-title":"Stroma AReactive Invasion Front Areas (SARIFA): a novel histopathologic biomarker in colorectal cancer patients and its association with the luminal tumour proportion","volume":"44","author":"Reitsam","year":"2024","journal-title":"Transl Oncol"},{"key":"10.1016\/j.ejca.2026.117035_bib11","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s40170-024-00349-z","article-title":"The relationship between Stroma AReactive Invasion Front Areas (SARIFA), Warburg-subtype and survival: results from a large prospective series of colorectal cancer patients","volume":"12","author":"Offermans","year":"2024","journal-title":"Cancer Metab"},{"issue":"9","key":"10.1016\/j.ejca.2026.117035_bib12","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1097\/PAS.0000000000002408","article-title":"Prognostic and Predictive Value of SARIFA-status Within Molecular Subgroups of Colorectal Cancer: Insights From the Netherlands Cohort Study","volume":"49","author":"Reitsam","year":"2025","journal-title":"Am. J. Surg. Pathol."},{"key":"10.1016\/j.ejca.2026.117035_bib13","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1038\/s43856-024-00589-6","article-title":"Converging deep learning and human-observed tumor-adipocyte interaction as a biomarker in colorectal cancer","volume":"4","author":"Reitsam","year":"2024","journal-title":"Commun Med"},{"key":"10.1016\/j.ejca.2026.117035_bib14","doi-asserted-by":"crossref","DOI":"10.1159\/000549919","article-title":"Tissue-Based Multiomic Exploratory Analysis of the uPa\/uPAR system and matrix metalloproteinases in SARIFA-positive gastrointestinal cancers","author":"Reitsam","year":"2026","journal-title":"Pathobiology"},{"issue":"3","key":"10.1016\/j.ejca.2026.117035_bib15","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/his.15501","article-title":"Stroma areactive invasion front areas (SARIFA) in 1,298 pT3\/pT4 colorectal cancers: A strong prognostic parameter complementing established morphological criteria","volume":"87","author":"Foersch","year":"2025","journal-title":"Histopathology"},{"key":"10.1016\/j.ejca.2026.117035_bib16","doi-asserted-by":"crossref","DOI":"10.1111\/his.70237","article-title":"Direct tumour-adipocyte contact \/ Stroma AReactive Invasion Front Area (TAC\/SARIFA) predicts adverse outcome in colorectal cancer: a focused evidence synthesis and meta-analysis","author":"Reitsam","year":"2026","journal-title":"Histopathology"},{"key":"10.1016\/j.ejca.2026.117035_bib17","doi-asserted-by":"crossref","DOI":"10.1002\/cac2.12360","article-title":"Lipid metabolism in pancreatic cancer: emerging roles and potential targets","volume":"42","author":"Yin","year":"2022","journal-title":"Cancer Commun"},{"key":"10.1016\/j.ejca.2026.117035_bib18","doi-asserted-by":"crossref","DOI":"10.1038\/s41586-025-08917-z","article-title":"Targeting PIKfyve-driven lipid metabolism in pancreatic cancer","volume":"642","author":"Cheng","year":"2025","journal-title":"Nature"},{"key":"10.1016\/j.ejca.2026.117035_bib19","doi-asserted-by":"crossref","DOI":"10.3892\/or.2023.8578","article-title":"Adipocytes promote pancreatic cancer migration and invasion through fatty acid metabolic reprogramming","volume":"50","author":"CAI","year":"2023","journal-title":"Oncol Rep"},{"key":"10.1016\/j.ejca.2026.117035_bib20","doi-asserted-by":"crossref","DOI":"10.1038\/cddis.2014.38","article-title":"Metabolism addiction in pancreatic cancer","volume":"5","author":"Blum","year":"2014","journal-title":"Cell Death Dis"},{"key":"10.1016\/j.ejca.2026.117035_bib21","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1186\/s12885-024-12519-9","article-title":"The concept of stroma areactive invasion front areas (SARIFA) as a new prognostic biomarker for lipid-driven cancers holds true in pancreatic ductal adenocarcinoma","volume":"24","author":"Grochowski","year":"2024","journal-title":"BMC Cancer"},{"key":"10.1016\/j.ejca.2026.117035_bib22","doi-asserted-by":"crossref","DOI":"10.1038\/s41416-023-02295-x","article-title":"TPX2 expression as a negative predictor of gemcitabine efficacy in pancreatic cancer","volume":"129","author":"Guenther","year":"2023","journal-title":"Br J Cancer"},{"key":"10.1016\/j.ejca.2026.117035_bib23","doi-asserted-by":"crossref","DOI":"10.1038\/s42256-024-00889-5","article-title":"Accelerating histopathology workflows with generative AI-based virtually multiplexed tumour profiling","volume":"6","author":"Pati","year":"2024","journal-title":"Nat Mach Intell"},{"key":"10.1016\/j.ejca.2026.117035_bib24","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-025-14751-3","article-title":"Spatially resolved analysis of TGF\/BMP signalling in pancreatic ductal adenocarcinoma by digital pathology identifies patient subgroups with adverse outcome","volume":"25","author":"Br\u00e4utigam","year":"2025","journal-title":"BMC Cancer"},{"issue":"2","key":"10.1016\/j.ejca.2026.117035_bib25","article-title":"Integrated genomic characterization of pancreatic ductal adenocarcinoma the cancer genome atlas research network *","volume":"32","author":"The Cancer Genome Atlas Research Network, Raphael BJ","year":"2017","journal-title":"Cancer Cell"},{"key":"10.1016\/j.ejca.2026.117035_bib26","doi-asserted-by":"crossref","DOI":"10.1158\/2159-8290.CD-12-0095","article-title":"The cBio cancer genomics portal: an open platform for exploring multidimensional cancer genomics data","volume":"2","author":"Cerami","year":"2012","journal-title":"Cancer Discov"},{"key":"10.1016\/j.ejca.2026.117035_bib27","doi-asserted-by":"crossref","DOI":"10.1126\/scisignal.2004088","article-title":"Integrative analysis of complex cancer genomics and clinical profiles using the cBioPortal","volume":"6","author":"Gao","year":"2013","journal-title":"Sci Signal"},{"key":"10.1016\/j.ejca.2026.117035_bib28","doi-asserted-by":"crossref","DOI":"10.1002\/ijc.34044","article-title":"The impact of adjuvant therapy on outcome in UICC stage I pancreatic cancer","volume":"151","author":"Guenther","year":"2022","journal-title":"Int J Cancer"},{"key":"10.1016\/j.ejca.2026.117035_bib29","doi-asserted-by":"crossref","DOI":"10.1111\/his.13508","article-title":"Tumour budding in pancreatic cancer revisited: validation of the ITBCC scoring system","volume":"73","author":"Karamitopoulou","year":"2018","journal-title":"Histopathology"},{"key":"10.1016\/j.ejca.2026.117035_bib30","doi-asserted-by":"crossref","DOI":"10.1186\/s13059-014-0550-8","article-title":"Moderated estimation of fold change and dispersion for RNA-seq data with DESeq2","volume":"15","author":"Love","year":"2014","journal-title":"Genome Biol"},{"key":"10.1016\/j.ejca.2026.117035_bib31","doi-asserted-by":"crossref","DOI":"10.1038\/ncomms3612","article-title":"Inferring tumour purity and stromal and immune cell admixture from expression data","volume":"4","author":"Yoshihara","year":"2013","journal-title":"Nat Commun"},{"key":"10.1016\/j.ejca.2026.117035_bib32","doi-asserted-by":"crossref","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"10.1016\/j.ejca.2026.117035_bib33","doi-asserted-by":"crossref","DOI":"10.3390\/cancers13194880","article-title":"Stroma areactive invasion front areas (SARIFA)\u2014a new easily to determine biomarker in colon cancer\u2014results of a retrospective study","volume":"13","author":"Martin","year":"2021","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.ejca.2026.117035_bib34","article-title":"Tumour budding is a strong and independent prognostic factor in pancreatic cancer","volume":"49","author":"Karamitopoulou","year":"2013","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.ejca.2026.117035_bib35","article-title":"The tumor\u2013stroma ratio and the immune microenvironment improve the prognostic prediction of pancreatic ductal adenocarcinoma","volume":"14","author":"Lu","year":"2023","journal-title":"Discov Oncol"},{"key":"10.1016\/j.ejca.2026.117035_bib36","doi-asserted-by":"crossref","DOI":"10.3390\/biom15030426","article-title":"The Prognostic, Predictive and Clinicopathological Implications of KRT81\/HNF1A- and GATA6-Based Transcriptional Subtyping in Pancreatic Cancer","volume":"15","author":"Guenther","year":"2025","journal-title":"Biomolecules"},{"key":"10.1016\/j.ejca.2026.117035_bib37","article-title":"The aging microenvironment is a determinant of immune exclusion and metastatic fate in pancreatic cancer","author":"Gupta","year":"2025","journal-title":"Cancer Res"},{"key":"10.1016\/j.ejca.2026.117035_bib38","doi-asserted-by":"crossref","DOI":"10.3390\/cancers15030994","article-title":"Alterations in natural killer cells in colorectal cancer patients with stroma areactive invasion front areas (SARIFA)","volume":"15","author":"Reitsam","year":"2023","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.ejca.2026.117035_bib39","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa1809775","article-title":"FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer","volume":"379","author":"Conroy","year":"2018","journal-title":"New Engl J Med"},{"key":"10.1016\/j.ejca.2026.117035_bib40","first-page":"43","article-title":"Pancreatic Adenocarcinoma: long-term outcomes of adjuvant therapy in the ESPAC4 phase iii trial","author":"Palmer","year":"2025","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ejca.2026.117035_bib41","doi-asserted-by":"crossref","DOI":"10.3892\/ijo.2026.5848","article-title":"Unveiling sex differences in pancreatic ductal adenocarcinoma: current evidence and future directions (Review)","volume":"68","author":"Rauschenberg","year":"2026","journal-title":"Int J Oncol"},{"key":"10.1016\/j.ejca.2026.117035_bib42","doi-asserted-by":"crossref","DOI":"10.3390\/ijms252312669","article-title":"Sex-related differences in pancreatic ductal adenocarcinoma progression and response to therapy","volume":"25","author":"Grahovac","year":"2024","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.ejca.2026.117035_bib43","first-page":"5","article-title":"Sex-specific differences in lipid and glucose metabolism","author":"Varlamov","year":"2014","journal-title":"Front Endocrinol (Lausanne)"},{"key":"10.1016\/j.ejca.2026.117035_bib44","doi-asserted-by":"crossref","DOI":"10.1136\/gutjnl-2025-337119","article-title":"Tumour-infiltrating adipocyte-derived 12,13-DiHOME subverts CD8T cell immunity in pancreatic ductal adenocarcinoma by promoting PPAR\u03b3-mediated ferritinophagy and tumour-associated neutrophil ferroptosis","author":"Luo","year":"2026","journal-title":"Gut"}],"container-title":["European Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0959804926008166?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0959804926008166?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:33:49Z","timestamp":1790800429000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0959804926008166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":44,"alternative-id":["S0959804926008166"],"URL":"https:\/\/doi.org\/10.1016\/j.ejca.2026.117035","relation":{},"ISSN":["0959-8049"],"issn-type":[{"value":"0959-8049","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Direct Tumor-Adipocyte Contact as a Prognostic Biomarker in Resected Pancreatic Ductal Adenocarcinoma","name":"articletitle","label":"Article Title"},{"value":"European Journal of Cancer","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ejca.2026.117035","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Faculty of Medicine, University of Augsburg, Augsburg, Germany. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"117035"}}