Yun Wang1,2, Hao-Cheng Lin1,2, Ma-Yan Huang1,3, Qiong Shao1,4, Zhi-Qiang Wang1,2, Feng-Hua Wang1,2, Yun-Fei Yuan1,5, Bin-Kui Li1,5, De-Shen Wang1,2, Pei-Rong Ding1,6, Gong Chen1,6, Xiao-Jun Wu1,6, Zhen-Hai Lu1,6, Li-Ren Li1,6, Zhi-Zhong Pan1,6, Peng Sun1,3, Shu-Mei Yan1,3, De-Sen Wan1,6, Rui-Hua Xu7,8, Yu-Hong Li9,10. 1. State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, 651# Dongfeng Road East, Guangzhou, 510060, People's Republic of China. 2. Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 3. Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 4. Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 5. Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 6. Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 7. State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, 651# Dongfeng Road East, Guangzhou, 510060, People's Republic of China. xurh@sysucc.org.cn. 8. Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. xurh@sysucc.org.cn. 9. State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, 651# Dongfeng Road East, Guangzhou, 510060, People's Republic of China. liyh@sysucc.org.cn. 10. Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. liyh@sysucc.org.cn.
Abstract
BACKGROUND: The Immunoscore was initially established to evaluate the prognosis of stage I/II/III colorectal cancer patients. However, the feasibility of the Immunoscore for the prognosis of colorectal cancer liver metastases (CRCLM) has not been reported. METHODS: Liver metastases in 249 CRCLM patients were retrospectively analyzed. The Immunoscore was assessed according to the counts and densities of CD3+ and CD8+ T cells in the central- and peritumoral areas by immunohistochemistry. The prognostic role of the Immunoscore for relapse-free survival (RFS) and overall survival (OS) was analyzed with Kaplan-Meier curves and Cox multivariate models, and confirmed via an internal validation. Receiver operating characteristic (ROC) curves were plotted to compare the prognostic values of the Immunoscore and the clinical risk score (CRS) system. RESULTS: CRCLM patients with high Immunoscores (> 2) had significantly longer RFS [median RFS (95% confidence interval; 95% CI) 21.4 (7.8-35.1) vs. 8.7 (6.8-10.5) months, P < 0.001] and OS [median OS (95% CI): not reached vs. 28.7 (23.2-34.2) months, P < 0.001] than those with low Immunoscores (≤ 2). After stratification by CRS, the Immunoscore retained a statistically significant prognostic value for OS. The areas under the ROC curves (AUROCs) of the Immunoscore and the CRS system for RFS were 0.711 [95% CI 0.642-0.781] and 0.675[95% CI 0.601-0.749] (P = 0.492), whereas the AUROC of the Immunoscore system for OS was larger than that of the CRS system [0.759 (95% CI 0.699-0.818) vs. 0.660 (95% CI 0.592-0.727); P = 0.029]. CONCLUSIONS: The Immunoscore of liver metastases can be applied to predict the prognosis of CRCLM patients following liver resection.
BACKGROUND: The Immunoscore was initially established to evaluate the prognosis of stage I/II/III colorectal cancerpatients. However, the feasibility of the Immunoscore for the prognosis of colorectal cancer liver metastases (CRCLM) has not been reported. METHODS:Liver metastases in 249 CRCLM patients were retrospectively analyzed. The Immunoscore was assessed according to the counts and densities of CD3+ and CD8+ T cells in the central- and peritumoral areas by immunohistochemistry. The prognostic role of the Immunoscore for relapse-free survival (RFS) and overall survival (OS) was analyzed with Kaplan-Meier curves and Cox multivariate models, and confirmed via an internal validation. Receiver operating characteristic (ROC) curves were plotted to compare the prognostic values of the Immunoscore and the clinical risk score (CRS) system. RESULTS: CRCLM patients with high Immunoscores (> 2) had significantly longer RFS [median RFS (95% confidence interval; 95% CI) 21.4 (7.8-35.1) vs. 8.7 (6.8-10.5) months, P < 0.001] and OS [median OS (95% CI): not reached vs. 28.7 (23.2-34.2) months, P < 0.001] than those with low Immunoscores (≤ 2). After stratification by CRS, the Immunoscore retained a statistically significant prognostic value for OS. The areas under the ROC curves (AUROCs) of the Immunoscore and the CRS system for RFS were 0.711 [95% CI 0.642-0.781] and 0.675[95% CI 0.601-0.749] (P = 0.492), whereas the AUROC of the Immunoscore system for OS was larger than that of the CRS system [0.759 (95% CI 0.699-0.818) vs. 0.660 (95% CI 0.592-0.727); P = 0.029]. CONCLUSIONS: The Immunoscore of liver metastases can be applied to predict the prognosis of CRCLM patients following liver resection.
Entities:
Keywords:
Colorectal cancer liver metastases; Immunoscore; Prognosis; Tumor-infiltrating lymphocyte
Authors: Frank Liang; Lisa M Nilsson; Fabian Byvald; Azar Rezapour; Helena Taflin; Jonas A Nilsson; Ulf Yrlid Journal: Cancers (Basel) Date: 2022-06-10 Impact factor: 6.575