Background: Nasopharyngeal carcinoma (NPC) is the fifth most common malignancy in Indonesia. Diagnosis of NPC is frequently established in late stage showing regional lymph node metastasis. Tumor-stroma ratio (TSR) has recently been identified as one of independent prognostic factor for several solid tumor, which low TSR (predomination of stromal component) correlates with unfavorable prognosis and increased risk of relapse.

Objective: This study aimed to investigate the correlation of TSR with tumor size and lymph node involvement in NPC.

Material and Method: A total of 68 hematoxylin-eosin stained histological slides of patients with NPC who underwent biopsy were reviewed. The percentage of tumor stroma was visually estimated with cut-off value of 50% stroma percentage. Patients with <50% stroma were categorized as high TSR group and those with ≥ 50% stroma were classified as low TSR group. Correlations of TSR with tumor size and lymph node involvement were determined using Spearman correlation test.

Result: Based on data, of 68 patients; 36 (52,9%) had low TSR and 32 (47,1%) had high TSR.  Tumor T2 had highest percentage in both low and high TSR (44,4% and 43,75%). The low TSR patients had higher number of positive N stage than high TSR.  TSR was not significantly correlated with tumor size (p=0,410) and lymph node involvement (p=0,507). These results demonstrated that TSR itself could not clearly predict progression of T&N stage of NPC.

Conclusion: Stroma percentage was not correlated with tumor size and lymph node involvement in NPC.