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494 PD1-positive tumor-infiltrating lymphocytes are associated with poor clinical outcome after pulmonary metastasectomy for colorectal cancer

2018; Elsevier BV; Volume: 138; Issue: 5 Linguagem: Inglês

10.1016/j.jid.2018.03.501

1523-1747

Yu‐Sun Chang, Desislava Ignatova, Dagmar Kollmann, Thomas Schweiger, Steffen Schwarz, Gerrit Lewik, Sebastian F. Schoppmann, Wolfram Hoetzenecker, Lars E. French, Walter Klepetko, Konrad Höetzenecker, Emmanuella Guenova,

Bladder and Urothelial Cancer Treatments

Pulmonary metastasectomy (PM) is performed in colorectal cancer (CRC) patients with oligometastatic spreading to the lungs. Patients with an aggressive tumor phenotype should be excluded from PM, since its benefit is outweighed by early tumor recurrence and impaired prognosis. Expression of PD-1 and its ligands are prognostic factors in a variety of primary tumors. However, their impact on patients' outcome in the setting of PM for CRC has not been evaluated before. 53 CRC patients with pulmonary metastases receiving PM with curative intent were included in this study. Tissue samples of resected pulmonary metastases and available corresponding primary tumors were collected and assessed for PD-1, PD-L1 and PD-L2 expression by tumor-infiltrating lymphocytes (TILs) and tumor cells. Expression patterns were correlated with clinical outcome parameters. PD-1 and PD-L1 expression was commonly found in TILs and tumor cells. Expression levels significantly differed between metastases and primary tumors. High PD-1 expression by TILs was associated with impaired overall survival. Additionally, the subgroup of patients, who experienced an upgrading in their TILs/PD1 status between primary and metastasis had a worse survival outcome compared with patients with the same grade or a downgrading. Thus, PD-1 expression by TILs is a strong prognostic marker in CRC patients with pulmonary spreading treated by PM.