Quantitative assessment of tumor-infiltrating lymphocytes in mismatch repair proficient colon cancer Journal Article


Authors: Jimenez-Rodriguez, R. M.; Patil, S.; Keshinro, A.; Shia, J.; Vakiani, E.; Stadler, Z.; Segal, N. H.; Yaeger, R.; Konishi, T.; Shimada, Y.; Widmar, M.; Wei, I.; Pappou, E.; Smith, J. J.; Nash, G.; Paty, P.; Garcia-Aguilar, J.; Weiser, M. R.
Article Title: Quantitative assessment of tumor-infiltrating lymphocytes in mismatch repair proficient colon cancer
Abstract: Tumor infiltrating lymphocytes (TIL), which represent host adaptive response to the tumor, were first identified at scanning magnification to select areas with the highest counts on hematoxylin and eosin slides, quantitated per high-power field (HPF), and analyzed for association with recurrence-free survival (RFS) in 848 patients. Highest TIL in a single HPF was analyzed as a continuous and categorical variable, and optimal cutoff analysis was performed to predict RFS. Highest TIL count in a single HPF ranged from 0 to 45, and the optimal cutoff for TIL high vs TIL low was determined to be ≥ 3 vs < 3 with a concordance probability estimate of 0.74. In the entire cohort, 5-year RFS was 90.2% (95% CI = 83.7–94.2) in TIL high compared to 78.9% (95% CI = 74.1–82.9) in TIL low (log rank P < .0001). TIL remained significant in the mismatch repair-proficient (pMMR) cohort where 5-year RFS was 94.6% (95% CI = 88.3–97.5) in TIL high compared to 77.9% (95% CI = 69.2–84.4) in TIL low (P = .008). On multivariable analysis, TIL and AJCC Stage were independently associated with RFS in the pMMR cohort. Qualitatively in the pMMR cohort, RFS in Stage II TIL high patients was similar to that in Stage I patients and RFS in Stage III TIL high was similar to that in Stage II TIL low patients. Assessment of TIL in a single HPF using standard H&E slides provides important prognostic information independent of MMR status and AJCC stage. © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.
Keywords: survival; colon cancer; mismatch repair; tumor-infiltrating lymphocytes
Journal Title: OncoImmunology
Volume: 9
Issue: 1
ISSN: 2162-4011
Publisher: Landes Bioscience  
Date Published: 2020-01-01
Start Page: 1841948
Language: English
DOI: 10.1080/2162402x.2020.1841948
PROVIDER: scopus
PMCID: PMC7671050
PUBMED: 33235819
DOI/URL:
Notes: Article -- Export Date: 1 December 2020 -- Source: Scopus
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MSK Authors
  1. Sujata Patil
    511 Patil
  2. Philip B Paty
    499 Paty
  3. Neil Howard Segal
    210 Segal
  4. Zsofia Kinga Stadler
    391 Stadler
  5. Jinru Shia
    720 Shia
  6. Martin R Weiser
    538 Weiser
  7. Rona Denit Yaeger
    316 Yaeger
  8. Garrett Nash
    263 Nash
  9. Efsevia Vakiani
    264 Vakiani
  10. Jesse Joshua Smith
    221 Smith
  11. Maria   Widmar
    76 Widmar
  12. Emmanouil Pappou
    91 Pappou
  13. Iris Hsin - chu Wei
    66 Wei