Intraepithelial T cells and tumor proliferation: Impact on the benefit from surgical cytoreduction in advanced serous ovarian cancer Journal Article
| Authors: | Adams, S. F.; Levine, D. A.; Cadungog, M. G.; Hammond, R.; Facciabene, A.; Olvera, N.; Rubin, S. C.; Boyd, J.; Gimotty, P. A.; Coukos, G. |
| Article Title: | Intraepithelial T cells and tumor proliferation: Impact on the benefit from surgical cytoreduction in advanced serous ovarian cancer |
| Abstract: | BACKGROUND: The aim of the study was to determine whether tumor-infiltrating lymphocytes and/or tumor mitotic activity could identify subgroups of patients with advanced serous epithelial ovarian cancer who would maximally benefit from aggressive surgical cytoreduction. METHODS: Snap-frozen specimens from 134 consecutive patients with stage III or IV serous or poorly differentiated ovarian adenocarcinoma undergoing primary debulking surgery from a single US institution were characterized based on CD3<sup>+</sup>, CD8 <sup>+</sup>, FoxP3<sup>+</sup> tumor-infiltrating lymphocytes, and Ki67 expression. Kaplan-Meier survival curves were estimated and compared using a log-rank statistic. A multivariate Cox model was used to estimate adjusted hazard ratios. Interactions were modeled using recursive partitioning based on maximal prognostic differentiation. RESULTS: Brisk intraepithelial CD8 <sup>+</sup> cells (P = .035) and low Ki67 expression (P = .042) portended prolonged survival. The T-cell infiltration was more likely to occur in tumors with high proliferation index. Patients whose tumors exhibited low Ki67 expression and high intraepithelial CD8<sup>+</sup> frequency had a 5-year survival rate of 73.3%. Patients with aggressive tumor behavior, that is, whose tumors exhibited low frequency of intraepithelial CD8<sup>+</sup> T cells or high Ki67 expression were more likely to draw benefit from aggressive surgical cytoreduction. Survival was similar for patients with brisk CD8<sup>+</sup> T cells who had optimal or suboptimal debulking. Likewise, survival was similar for patients with low Ki67 expression who had optimal or suboptimal debulking. CONCLUSIONS: For the first time, these novel interactions of T cells, tumor proliferation index, and surgical treatment reveal that biological prognosticators may be useful for surgical decision making in ovarian cancer. © 2009 American Cancer Society. |
| Keywords: | cancer survival; human tissue; treatment outcome; cancer surgery; survival rate; major clinical study; advanced cancer; cancer staging; ovarian cancer; surgical cytoreduction; t cells; tumor proliferation; cd3 antigen; cd8 antigen; ki 67 antigen; transcription factor foxp3; antigen expression; cd8+ t lymphocyte; cell proliferation; cytoreductive surgery; lymphocyte proliferation; medical decision making; mitosis; ovary adenocarcinoma; t lymphocyte; tumor associated leukocyte; antigens, cd3; cd8-positive t-lymphocytes; cystadenoma, serous; forkhead transcription factors; ki-67 antigen; lymphocytes, tumor-infiltrating; ovarian neoplasms; t-lymphocytes |
| Journal Title: | Cancer |
| Volume: | 115 |
| Issue: | 13 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2009-07-01 |
| Start Page: | 2891 |
| End Page: | 2902 |
| Language: | English |
| DOI: | 10.1002/cncr.24317 |
| PUBMED: | 19472394 |
| PROVIDER: | scopus |
| PMCID: | PMC2754811 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 4" - "Export Date: 30 November 2010" - "CODEN: CANCA" - "Source: Scopus" |
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