Histopathological prognostic markers in metastatic lung adenocarcinoma, validation of stromal fibrosis and immunoscore as easy to interpret findings and their correlation with survival

Autor: Carlos Vargas, Zyanya Lucia Zatarain-Barrón, Jenny Mireya Ávila Coy, Luis Leonardo Rojas Puentes, Luis Eduardo Pino, Melissa Andrea Bravo Espinosa, Hernán Carranza, Oscar Arrieta, D. Mayorga, Jorge Otero, Andres Felipe Cardona Zorrilla, Claudio Martin, Rafael Rosell, July Rodriguez, Christian Rolfo, Alejandro Ruiz-Patiño, Gonzalo Recondo, Feliciano Barrón, Diana Carolina Sotelo Rodríguez, Pilar Archila
Rok vydání: 2020
Předmět:
Zdroj: Journal of Clinical Oncology. 38:e21566-e21566
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2020.38.15_suppl.e21566
Popis: e21566 Background: Several histopathological markers have been associated with immune system activity and its relationship with clinical outcomes in lung cancer. Determination of tumor infiltrating lymphocytes as well as specific subpopulations could reveal cytotoxic potential. Additionally, changes in stromal composition and fibrosis could also reflect potential cellular interactions with the tumor lesions. In this study we validate these two findings as potential prognostic factors. Methods: A retrospective cohort analysis of patients with advanced lung adenocarcinoma treated in a reference center in Bogota, Colombia was conducted. Demographic as well as treatment variables were collected between January 2018 and December 2019. In addition to clinical outcomes, the percentage of stromal fibrosis and immunoscore were estimated for all biopsy samples by a trained oncological pathologist. Results: A total of 133 patients were included. Male predominance (51.1%) with Karnofsky performance scores (KPS) greater than 80 and 19% of prior cigarette exposure (26 patients) was identified in the cohort. Median overall survival of the cohort was 27.1 months (95%CI 22.1-NA) and progression free survival of 19.4 months (95%CI 18-24.5 months). Percentage of fibrous stroma and immunoscore were associated with a benefit in both OS and PFS. For patients who presented with a low stromal fibrosis, defined as harboring less than 10%, OS reached a median of 25.1 months (95%CI 21.5- 40.5 months) compared to 38.7 months for patients with high fibrosis (95%CI 27.7 months – NA), (p = 0.02). In terms of immunoscore, values under 40% were associated with a longer median OS (38.7 months, [95%CI 31.3- 58.6 months] vs 22.1 months [95%CI19.8- 42.3 months], p < 0.001). Immunoscore and stromal fibrosis were not codependent variables (p < 0.001), suggesting that these markers offer independent prognostic value with regards to OS. Conclusions: Stromal fibrosis and immunoscore serve as prognostic factors that could be easily interpreted and evaluated in order to offer prognostic classification of patients with metastatic adenocarcinoma of the lung.
Databáze: OpenAIRE
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