Logo image
Back
The prognostic value of CD3+ tumor-infiltrating lymphocytes for stage II colon cancer according to use of adjuvant chemotherapy: A large single-institution cohort study: TILs for ADJ-untreated stage II colon cancer
Journal article   Open access   Peer reviewed

The prognostic value of CD3+ tumor-infiltrating lymphocytes for stage II colon cancer according to use of adjuvant chemotherapy: A large single-institution cohort study: TILs for ADJ-untreated stage II colon cancer

Edoardo Francini, Fang Shu Ou, Stefano Lazzi, Roberto Petrioli, Andrea G. Multari, Guido Pesola, Luciana Messuti, Elena Colombo, Virginia Livellara, Serena Bazzurri, …
Translational oncology, Vol.14(2), 100973
02/01/2021
DOI: 10.1016/j.tranon.2020.100973
PMCID: PMC7750416
PMID: 33338878
url
https://doi.org/10.1016/j.tranon.2020.100973View
Published (Version of record) Open Access

Abstract

Background: High tumor infiltrating lymphocytes (TILs) density was previously shown to be associated with favorable prognosis for patients with colon cancer (CC). However, the impact of TILs on overall survival (OS) of stage II CC patients who received adjuvant chemotherapy (ADJ) or not (no-ADJ) is unknown. We assessed the prognostic value of CD3+ TILs in stage II CC patients according to whether they had ADJ or not. Methods: Patients treated with curative surgery for stage II CC (2002–2013) were selected from the Santa Maria alle Scotte Hospital registry. TILs at the invasive front, center of tumor, and stroma were determined by immunohistochemistry and manually quantified as the rate of TILs/total tissue areas. High TILs (H-TILs) was defined as >20%. Patients were categorized as high or low TILs (L-TILs) and ADJ or no-ADJ. Results: Of the 678 patients included, 137 (20%) received ADJ and 541 (80%) did not. The distribution of the 4 groups were: 16% (L-TIL/ADJ), 64% (L-TIL/no-ADJ), 5% (H-TIL/ADJ), 15% (H-TIL/no-ADJ). Compared to H-TILs/no-ADJ, ADJ patients showed a significantly increased OS (P<.01) regardless of the TILs rate whereas L-TILs/no-ADJ had significantly decreased OS and higher risk of death (HR=1.41; 95% CI, 1.06–1.88; P<.0001). On multivariable analysis, the unfavorable prognostic value of L-TILs (vs. H-TILs) for no-ADJ patients was confirmed (HR=1.36; 95% CI 1.02, 1.82; P=.0373). Conclusion: Low CD3+ TILs rate was associated with shorter OS in those with stage II colon cancer who did not receive adjuvant therapy. Low CD3+ TILs could be considered an additional risk factor for still ADJ-untreated stage II CC patients, which could facilitate clinical decision making.
 Colorectal cancer Fluoropyrimidines Post-surgery treatment Prognostic marker T-cells

Details

Metrics

1 Record Views
14 Times Cited - Web of Science
Logo image