The Degree of Fibrous Stroma in Pancreatic Ductal Adenocarcinoma Does Not Serve as A Reliable Marker for Survival: A Case Study

Abstract

1. Introduction: The fibrous stroma (FS) in pancreatic ductal adenocarcinoma develops due to chronic injury during tumor invasion, yet emerging evidence indicates its crucial role in tumor invasion. 2. Aims: This study aims to assess the fibrous stroma percentage (FSP) in pancreatic ductal adenocarcinoma (PDAC) tissue and its corelation with various factors including gender, tumor size, lymphatic and vascular invasion, distant metastases, tumor grade, disease stage and overall survival. 3. Materials and Methods: We enrolled 62 patients categorized into two groups based on FSP percentage in tumor tissue: group with FSP ≤ 50% and group with FSP > 50%. FSP was determined using the Prika method, modified to fit two-tiered system of low and high degree of FS. Correlations between FSP and gender, tumor size, lymphatic and vascular invasion, distant metastases, stage, grade, and survival were assessed. 4. Results: FSP in tumor tissue exceeding 50% was observed more in females compared to males. FSP more than 50% was prevalent in larger tumors, and in tumors infiltrating the celiac plexus. While FSP in stage III tumors was slightly higher, no statistically significant difference was found. Interestingly, FSP below 50% was more common in patients with distant metastases. 5. Conclusions: Although higher FSP correlated with larger tumors, poorer differentiation, more advanced stage, and presence of lymphatic invasion, patients with FSP below and above 50% did not significantly differ in terms of survival time.