Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. The tumour stroma ratio (TSR) is a prognostic biomarker for predicting recurrence-free survival following hepatectomy for hepatocellular carcinoma.

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Hepatocellular carcinoma (HCC) has a high morbidity and mortality burden worldwide. In this study, researchers aimed to assess the prognostic value of two biomarkers, the tumour stroma ratio (TSR) and PD-L1, in patients who had previously undergone hepatectomy for HCC. TSR is defined as the proportion of tumour cells to tumour stromal cells. The tumour stroma is known to influence tumour growth, invasion, and metastasis. PD-L1 is a biomarker, which is highly expressed by tumour stromal cells. In this study, researchers collected data from 95 participants from Xiangya Hospital, Central South University, China. All patients had undergone hepatectomy for HCC, with no previous non-surgical treatments. To quantify the TSR, they conducted a blinded assessment of pathology slides, with two examiners independently assessing each slide. PD-L1 expression was determined via immunohistochemistry. Participants were classified based on their TSR as stroma-high or stroma-low. The authors determined that recurrence-free survival (RFS) after liver resection was shorter in the stroma-high group compared to the stroma-low group, with mean RFS of 14.5 and 27 months respectively. They also found that PD-L1 expression was greater in the stroma-high group compared to the stroma-low group (p = .03). This study demonstrates that the TSR may be a useful biomarker for predicting recurrence-free survival after hepatectomy for HCC. Given that PD-L1 expression was found to be greater for the stroma-high group, the authors suggest that PD-L1 may be a useful therapeutic target for immunotherapy to improve clinical outcomes. A limitation of this study is the small sample size of 95 participants. Future research may assess the utility of TSR and PD-L1 as prognostic biomarkers in a larger cohort.

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