Assessment of Tumor-infiltrating Lymphocytes Predicts the Behavior of Early-stage Oral Tongue Cancer

Abstract

Tumor-infiltrating lymphocytes (TILs) have shown a promising prognostic value in many epithelial cancers. We sought to assess the prognostic value of TILs in a multicenter cohort of early oral tongue squamous cell carcinoma (OTSCC). The percentage of TILs was assessed on the surgical resection slides stained wit h hematoxylin and eosin (HE). The assessment of TILs was performed in the stromal compartment and in the intra-epithelial compartment (at the invasive front and at the center of the tumor). We followed the method that was described recently by the International Immuno-Oncology Biomarker Working Group for the assessment of TILs. A total of 308 cases from the five Finnish university hospitals and from A.C. Camargo Cancer Center, São Paulo, Brazil were included. We found a promising prognostic value for stromal TILs at the invasive front in the multivariable analysis with a hazard ratio of 2.61 (95%CI 1.77-3.83; P<0.001) for overall survival, 1.99 (95%CI 1.07-3.69; P=0.040) for disease-specific survival, and 1.94 (95%CI 1.14-3.29; P=0.020) for disease-free survival. In conclusion, evaluation of TILs is simple and can aid in identifying the high-risk cases of early OTSCC. The method introduced by the International Immuno-Oncology Biomarker Working Group can be used for standardized determination of TILs in early OTSCC.

Histological characteristics of early‐stage oral tongue cancer in young versus older patients: A multicenter matched‐pair analysis

“…We have earlier established that some histopathological characteristics are independently associated with prognosis of early‐stage OTSCC patients (Almangush et al, , , ; Heikkinen et al, ). A previous study which compared stromal myofibroblast quantity in matched young and older OTSCC patients found no significant differences between both groups (Fonseca et al, ).…”

“…The histopathological features extracted for comparison included those often included in pathology reports such as WHO tumor grade (Kademani et al, ), DOI (Brierley, Gospodarowicz, & Wittekind, ), PNI (Brandwein‐Gensler et al, ), and WPOI (Brandwein‐Gensler et al, ), in addition to TB (Almangush et al, ), TSR (Almangush et al, ), TILs (Heikkinen et al, ), and histological risk score (HRS) (Brandwein‐Gensler et al, ) (Table ). These histopathological features were scored as illustrated in Figure .…”

“…These histopathological features were scored as illustrated in Figure . The procedures for evaluating the parameters studied are outlined in the published studies (Almangush et al, , ; Brandwein‐Gensler et al, ; Heikkinen et al, ; Tam, Amit, Zafereo, Bell, & Weber, ). Cross‐tabulation analysis of the differences in histopathological characteristics and other variables between paired patients groups were done.…”

Biopsy Quality is Essential for Preoperative Prognostication in Oral Tongue Cancer

“…TILs were evaluated at the invasive front as also previously described: percentage of stroma occupied by lymphocytes. Scanning was done at low magni cation (x4) and the TSR was assessed under high magni cation (x20) [11]. Based on previous studies, TSR and TILs were divided into high and low categories using 50% and 20% as the thresholds, respectively [10,11].…”

“…In resection samples, several tumor-related histological features such as depth of invasion (DOI), worst pattern of invasion (WPOI), tumor budding, budding and depth of invasion (BD) score, as well as some stromal features such as tumor stroma ratio (TSR) and tumor-in ltrating lymphocytes (TILs) have been identi ed in several studies as being of signi cant prognostic potential in OTSCC [8][9][10][11]. Notably, the latest AJCC/UICC TNM classi cation of head and neck tumors has signi cantly rede ned the T staging, making DOI an integral part of the pathologic TNM classi cation with every 5 mm depth increment automatically upstaging the T stage to a higher one (T1 to T2 -5 mm; T2 to T3 -10 mm).…”