T cell infiltrate predicts long-term survival following resection of colorectal cancer liver metastases Journal Article


Authors: Katz, S. C.; Pillarisetty, V.; Bamboat, Z. M.; Shia, J.; Hedvat, C.; Gonen, M.; Jarnagin, W.; Fong, Y.; Blumgart, L.; D'Angelica, M.; DeMatteo, R. P.
Article Title: T cell infiltrate predicts long-term survival following resection of colorectal cancer liver metastases
Abstract: Background: While tumor infiltrating lymphocytes (TIL) have been shown to independently predict survival in primary colorectal cancer, the prognostic implications of TIL in resectable colorectal cancer liver metastases (CRCLM) have not been previously defined. This study examines the correlation between TIL numbers and survival following hepatic resection. Methods: We studied patients who survived ≤2 or ≥10 years following CRCLM resection. Immunohistochemistry was performed on tissue microarrays (TMAs) to determine the number of T cells within CRCLM. Correlation between TIL frequency and ≤2 or ≥10 year survival was determined while controlling for established prognostic factors. Results: Of 162 patients, 104 survived ≤2 years and 58 survived ≥10 years. Independent correlates of 10-year survival following CRCLM resection included a high number of CD8 T cells, a low number of CD4 T cells, and a clinical risk score of ≤2 (P < 0.001). Among 10-year survivors, 31% of patients had a high number of CD8 T cells compared with 8% for ≤2 year survivors (P < 0.01). Surprisingly, only 22% of 10-year survivors had a high number of CD4 T cells, in contrast to 69% of those who died within 2 years (P < 0.001). The combination of CD8 and CD4 T cell counts was a more powerful predictor of survival than either marker alone. Conclusions: CRCLM T cell number is an independent correlate of long-term survival following liver resection. We conclude that CRCLM TIL analysis represents a potentially powerful prognostic tool which will require further validation prior to broad application. © 2009 Society of Surgical Oncology.
Keywords: immunohistochemistry; adult; cancer survival; controlled study; human tissue; treatment outcome; aged; aged, 80 and over; middle aged; cancer surgery; survival rate; major clinical study; liver neoplasms; follow up; neoplasm staging; prospective studies; colorectal cancer; cd8+ t lymphocyte; tumor associated leukocyte; cd8-positive t-lymphocytes; lymphocytes, tumor-infiltrating; time factors; risk assessment; colorectal neoplasms; immunoenzyme techniques; survival time; liver metastasis; cd4+ t lymphocyte; cd4-positive t-lymphocytes; cell count; tissue microarray
Journal Title: Annals of Surgical Oncology
Volume: 16
Issue: 9
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2009-09-01
Start Page: 2524
End Page: 2530
Language: English
DOI: 10.1245/s10434-009-0585-3
PUBMED: 19568816
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 3" - "Export Date: 30 November 2010" - "CODEN: ASONF" - "Source: Scopus"
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MSK Authors
  1. Leslie H Blumgart
    352 Blumgart
  2. Ronald P DeMatteo
    637 DeMatteo
  3. Cyrus Hedvat
    126 Hedvat
  4. Mithat Gonen
    1028 Gonen
  5. Steven C Katz
    33 Katz
  6. Jinru Shia
    714 Shia
  7. William R Jarnagin
    903 Jarnagin
  8. Yuman Fong
    775 Fong
  9. Zubin Mickey Bamboat
    33 Bamboat