Objective: Recently, tumor-stroma ratio (TSR) has been identified as a strong predictor for survival in colorectal cancer. Despite an identical biology clinical implications are quite different for colon and rectal cancer regarding to anatomical differences. Method: TSR was estimated on H&E stained histological sections of 154 patients who underwent resection for rectal adenocarcinoma between 1996 and 2006. None of these patients had received neoadjuvant chemo-or radiotherapy. The TSR was determined, by two independent investigators, in different layers of the rectal wall at the point of highest tumor infiltration and at the border of the tumor. TSRs were categorized into three categories: TSR-low, TSR-moderate and TSR-high.