Lymphocytic infiltration areas (immunoreactive) are frequently found in ovarian cancer, which is associated with a better prognosis and increased survival. Therefore, the study of different patterns and degree of infiltration would help us to better understand the relationship between immune and tumor cells and its prognostic implications.
This retrospective study includes samples from 57 patients with high grade serous ovarian cancer (HGSOC) who underwent cytoreductive surgery. The pattern of infiltration, localization and degree of lymphocyte infiltration in the tumor was evaluated. A set of clinical variables such as smoking, age, type of surgery, intention of treatment, type of response, as well as lymphocytic infiltration were evaluated to assess prognosis.
In our cohort, the median age was 61.5 years, there were 60% of smokers, and most of the cases were FIGO stages III and IV (15.3%, stage I, 8.5% stage II, 54.3% stage III and 22% stage IV). As expected, patients over 65 years, as well as the group of more advanced stages (III and IV) showed a shorter overall survival (OS, 30.17 vs 99.90 months, p = 0.009; 38.73 months vs NR, p = 0.005, respectively). Smoking status was also analyzed but no significant effect on survival was found (OS, p = 0.935). Interestingly, patients with an intratumoral lymphocyte infiltrate had better prognosis compared to the group that had only a peritumoral pattern (OS, 44.57 months vs NR, p = 0.041). In addition, those with a diffuse infiltration pattern presented a better prognosis compared to those with a focal pattern (OS, 20.20 months vs NR p = 0.003). Finally, a tendency for a better OS was seen for those patients with a strong degree of infiltration in the tumor.
HGSOC represents a group of highly immunoreactive tumors. Those with the best prognosis are represented by an intratumoral, diffuse pattern with a strong degree of infiltration, these findings could open a new window for therapeutic approaches in HGSOC.
Clinical trial identification
Legal entity responsible for the study
Fundación de Investigación Hospital General de Valenecia
All authors have declared no conflicts of interest.