Evidence map›Paper›PMID 40127161›Full record

SynthesisOral diseases2025

Tumor-Stroma Ratio in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

Gennaro Musella, Martina Coppini, Fábio França Vieira E Silva, Giuseppina Campisi, Mario Pérez-Sayáns, Vito Carlo Alberto Caponio, Alejandro I Lorenzo-Pouso

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Oral diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Gennaro MusellaDepartment of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.ORCID https://orcid.org/0009-0005-3576-4670
Martina CoppiniDepartment of Precision Medicine in Medical, Surgical and Critical Care, University of Palermo, Palermo, Italy.ORCID https://orcid.org/0000-0002-0834-1841
Fábio França Vieira E SilvaOral Medicine, Oral Surgery and Implantology Unit (MedOralRes Group), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, A Coruña, Spain.ORCID https://orcid.org/0000-0001-8389-086X
Giuseppina CampisiDepartment of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy.ORCID https://orcid.org/0000-0002-9443-0495
Mario Pérez-SayánsOral Medicine, Oral Surgery and Implantology Unit (MedOralRes Group), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, A Coruña, Spain.ORCID https://orcid.org/0000-0003-2196-9868
Vito Carlo Alberto CaponioDepartment of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.ORCID https://orcid.org/0000-0001-5080-5921
Alejandro I Lorenzo-PousoOral Medicine, Oral Surgery and Implantology Unit (MedOralRes Group), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, A Coruña, Spain.ORCID https://orcid.org/0000-0002-9180-4703

Funding

European Union-Next Generation EU through the Italian Ministry of University and Research under PNRR-M4C2-I1.3 Project PE_00000019 "HEAL ITALIA HEALTH EXTENDED ALLIANCE FOR INNOVATIVE THERAPIES, ADVANCED LAB-RESEARCH, AND INTEGRATED APPROACHES OF PRECISION MEDICINE" to Vito Carlo Alberto Caponio and Gennaro Musella; CUP D73C22001230006. The views and opinions expressed are those of the authors only and do not necessarily reflect those of the European Union or the European Commission PE_00000019-D73C22001230006
6 · The paper itself

Abstract

backgroundTumor-stroma ratio (TSR) has been recognized as a significant prognostic factor in various cancers. This systematic review evaluates the role of TSR in head and neck squamous cell carcinoma (HNSCC) and its association with patient outcomes such as overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), and lymph node metastasis (LNM).

methodsA comprehensive search was conducted across Scopus, Embase, PubMed, and Web of Science. Nineteen studies were included. Data extraction and quality assessment were performed progressively, with meta-analyses. All studies assessed TSR using hematoxylin and eosin staining of tissue samples. The meta-analyses focused on the impact of TSR on OS, DFS, DSS, and LNM, providing pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding confidence intervals (CIs).

resultsMeta-analysis revealed a significant association between TSR and OS (HR 1.99, 95% CI 1.71-2.32, p < 0.001), DFS (HR 2.07, 95% CI 1.80-2.39, p < 0.001), DSS (HR 2.33, 95% CI 1.95-2.78, p < 0.001), and LNM (OR 1.76, 95% CI 1.15-2.70, p = 0.01). Minimal to low heterogeneity was detected among studies, and no publication bias was observed.

conclusionsTSR can effectively identify high-risk patients, being a reliable prognostic marker that could be readily integrated into routine pathology practice for HNSCC.

Indexed as

Head and Neck NeoplasmsSquamous Cell Carcinoma of Head and NeckStromal CellsDisease-Free SurvivalHumansLymphatic MetastasisPrognosisbiomarkerhead and neck cancerhead and neck neoplasmsprognosticsystematic review and meta‐analysistumor–stromatumor–stroma ratio

Identifiers

PMID40127161
PMCPMC12423486

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.