Novel TME-Based Risk Score Redefines Prognosis in CRC

Background: Conventional colorectal cancer (CRC) staging depends on the TNM system, yet clinical outcomes within the same stage remain significantly heterogeneous. Modern oncology emphasizes that the tumor microenvironment (TME) is a primary driver of invasion and metastasis. Beyond traditional markers like lymphovascular invasion, parameters such as tumor budding (TB), tumor-infiltrating lymphocytes (TILs), tumor–stroma ratio (TSR), and stromal maturity offer deeper insights into the biological behavior of the malignancy. Objective: To develop and validate a novel "Risk Score" classification system based on these 4 histopathological TME features to predict disease-free survival (DFS) and overall survival (OS) in primary operable CRC. Design: Retrospective study. Methods: This retrospective analysis was conducted on 499 Stage I to III CRC patients who underwent radical resection. These patients were randomized into training and validation cohorts. Pathologists blinded to clinic more...