{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:51:00Z","timestamp":1780375860566,"version":"3.54.1"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T00:00:00Z","timestamp":1599868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>One of the objectives of current research is to customise the treatment of cancer patients. The achievement of this objective requires stratification of patients based on the most significant prognostic factors. The aims of this study were to evaluate the prognostic value of the tumour\u2013stroma ratio (TSR), defined as the proportion of tumour cells relative to surrounding stroma, in patients with oral tongue squamous cell carcinoma (OTSCC), and to develop a prognostic nomogram based on the most significant clinicopathological features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Clinicopathological data of 211 patients treated at \u2018Ospedali Riuniti\u2019 General Hospital (Ancona, Italy) for OTSCC were collected. One hundred and thirty\u2010nine patients were restaged according to the 8th edition American Joint Committee on Cancer (AJCC) staging system. Evaluation of the TSR was performed on haematoxylin and eosin\u2010stained slides, and correlation with survival outcomes was evaluated. In addition, with the aim of integrating the independent value of the TSR with the 8th edition AJCC staging system, a prognostic nomogram for OTSCC has been developed. OTSCC with a low TSR (i.e. a high proportion of stroma and a low proportion of tumour cells) was shown to have negative prognostic value in terms of disease\u2010specific survival, with a hazard ratio (HR) of 1.883 and a 95% confidence interval (CI) of 1.033\u20133.432 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.039), and overall survival (HR\u00a0=\u00a01.747, 95% CI 0.967\u20133.154; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.044), independently of other histological and clinical parameters. For the cohort of 139 patients restaged according to the 8th edition AJCC staging system, variables correlating with a poor prognosis were: the TSR, perineural invasion, and sex. The nomogram built on these parameters showed good predictive capacity, outperforming the 8th edition AJCC staging system in stratifying disease\u2010specific survival in OTSCC patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Including the TSR in the predictive model could improve risk stratification of OTSCC patients and aid in making treatment decisions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14202","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T08:41:17Z","timestamp":1594111277000},"page":"810-822","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Addition of the tumour\u2013stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma"],"prefix":"10.1111","volume":"77","author":[{"given":"Marco","family":"Mascitti","sequence":"first","affiliation":[{"name":"Department of Clinical Specialistic and Dental Sciences Marche Polytechnic University Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khrystyna","family":"Zhurakivska","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine Foggia University Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucrezia","family":"Togni","sequence":"additional","affiliation":[{"name":"Department of Clinical Specialistic and Dental Sciences Marche Polytechnic University Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito C A","family":"Caponio","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine Foggia University Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4106-314X","authenticated-orcid":false,"given":"Alhadi","family":"Almangush","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Helsinki Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Balercia","sequence":"additional","affiliation":[{"name":"Department of Oral and Head\u2010Neck Surgery Umberto I General Hospital Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Balercia","sequence":"additional","affiliation":[{"name":"Department of Oral and Head\u2010Neck Surgery Umberto I General Hospital Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Rubini","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Public Health Marche Polytechnic University Ancona 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