Chronic inflammation in tumor stroma is an independent predictor of prolonged survival in epithelioid malignant pleural mesothelioma patients Journal Article

   

Authors:	Suzuki, K.; Kadota, K.; Sima, C. S.; Sadelain, M.; Rusch, V. W.; Travis, W. D.; Adusumilli, P. S.
Article Title:	Chronic inflammation in tumor stroma is an independent predictor of prolonged survival in epithelioid malignant pleural mesothelioma patients
Abstract:	This study aims to determine whether a semi-quantitative assessment of inflammatory response in tumor and stroma on routine hematoxylin and eosin-stained (H&E) slides can predict survival in patients with epithelioid malignant pleural mesothelioma (MPM). H&E sections of 175 epithelioid MPM specimens from a single institution (1989-2009) were reviewed. Patients who received neoadjuvant chemotherapy were excluded from analysis. Each tumor was histologically assessed for acute and chronic inflammatory response both within the tumor and the stromal component. Inflammatory response was graded: low (none to mild infiltrate) or high (moderate to severe infiltrate). Log-rank test and Cox proportional hazards regression were used to investigate the association between the degree of inflammation (acute/tumor, acute/stroma, chronic/tumor, and chronic/stroma) and overall survival (OS). Patients with high chronic inflammatory response in stroma (n = 59) had improved survival compared to low (n = 116) (median OS = 19.4 vs. 15.0 months, P = 0.01). This prognostic stratification remained significant in stage III patients (median OS = 16.0 vs. 9.3 months, P = 0.03). In multivariate analysis, chronic inflammation in stroma was an independent predictor of survival (HR = 0.659, 95% CI 0.464-0.937, P = 0.02). While high degree of chronic inflammatory cell infiltration in the stromal component was associated with improved overall survival, degree of other inflammatory responses did not show significant correlation with OS. Our study for the first time investigates inflammatory response in tumor and stroma and not only suggests the prognostic value of inflammatory response in epithelioid MPM but also provides rationale for investigation of immunotherapy to benefit epithelioid MPM patients. © 2011 Springer-Verlag.
Keywords:	adult; cancer survival; controlled study; aged; major clinical study; overall survival; histopathology; cancer staging; disease association; tumor localization; cell infiltration; clinical assessment; prediction; disease severity; immune response; quantitative analysis; malignant mesothelioma; pleura mesothelioma; stroma; eosin; hematoxylin; chronic inflammation; epithelioid mesothelioma; connective tissue tumor; tumor stroma
Journal Title:	Cancer Immunology, Immunotherapy
Volume:	60
Issue:	12
ISSN:	0340-7004
Publisher:	Springer
Date Published:	2011-12-01
Start Page:	1721
End Page:	1728
Language:	English
DOI:	10.1007/s00262-011-1073-8
PROVIDER:	scopus
PUBMED:	21769693
PMCID:	PMC6250069
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-82355182060&partnerID=40&md5=aba775f17dbc2e47dec2476567747a24
Notes:	--- - "Cited By (since 1996): 1" - "Export Date: 3 January 2012" - "CODEN: CIIMD" - "Source: Scopus"

https://synapse.mskcc.org/synapse/works/has_related_data_chk/16471