Prognostic features of the tumour microenvironment in oesophageal adenocarcinoma

Oesophageal adenocarcinoma (OAC) is a disease with an incredibly poor survival rate and a complex makeup. The growth and spread of OAC tumours are profoundly influenced by their surrounding microenvimnment and the properties of the tumour itself. Constant crosstalk between the tumour and its micmenvironment is key to the survival of the tumour and ultimately the death of the patient. The tumour micmenvironment (TME) is composed of a complex milieu of cell types including cancer associated fibroblasts (CAFs) which make up the tumour stroma, endothelial cells which line blood and lymphatic vessels and infiltrating immune cell populations. These various cell types and the tumour constantly communicate through environmental cues including fluctuations in pH, hypoxia and the release of mitogens such as cytokines, chemokines and growth factors, many of which help promote malignant progression. Eventually clusters of tumour cells such as tumour buds break away and spread through the lymphatic system to nearby lymph nodes or enter the circulation forming secondary metastasis. Collectively, these factors need to be considered when assessing and treating patients clinically. This review aims to summarise the ways in which these various factors are currently assessed and how they relate to patient treatment and outcome at an individual level.

Automated summary

Oesophageal adenocarcinoma (OAC) is a disease with a low survival rate and complex makeup, with tumour growth and spread influenced by the surrounding microenvironment. A constant communication between tumour and microenvironment, including various cell types and environmental cues, plays a key role in disease progression and metastasis. These factors must be considered in assessing and treating patients clinically.