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Prognostic Value of Tumor-Infiltrating Lymphocytes and Neutrophil-to-Lymphocyte Ratio in Patients with Advanced Ovarian Cancer

Conference Correspondent

Tumor-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio are used as independent markers for prognosis in different tumors. However, the value of these markers when used in combination is unknown. Researchers sought to study the prognostic significance of tumor-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio when used in combination in patients with advanced ovarian cancer.

An observational, single-center retrospective analysis of patients with advanced-stage ovarian cancer was performed. Following informed consent, histological samples of ovarian tissue were collected, and tissue microarrays were constructed. Immunohistochemical staining of the arrays was performed for the tumor-infiltrating lymphocytes study. Samples were categorized by amount of tumor-infiltrating lymphocytes in relation to total area.

A cohort of 135 patients with advanced-stage ovarian cancer treated between 2002 and 2019 was analyzed. Of these, histological samples were requested in 92 patients. Patients had a median overall survival of 56 months. Stage III ovarian cancer was present in 80% of patients and stage IV in 20%. Histology revealed papillary serous carcinoma in 87.2% of patients.

TIL-CD3 infiltration of <25% was found in 75% of patients. The median neutrophil-to-lymphocyte ratio was 3.72. Overall survival was higher in patients with TIL-CD3 infiltration >25% and neutrophil-to-lymphocyte ratio of <3.72. Combined analysis of tumor-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio stratified patients into 2 subgroups: those with <25% TIL-CD3 infiltration and those with ≥25% infiltration. Disease-free survival was different between the 2 groups, with median disease-free survival of 11.49 months for patients with <25% infiltration compared with 21.94 months for patients with infiltration of ≥25%. In addition, multivariate analysis demonstrated an independent prognostic value in tumor-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio in overall survival and disease-free survival.

The combination of the assessment of tumor-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio increases their prognostic value in patients with advanced-stage ovarian cancer. Researchers conclude that this combined prognostic factor could be useful in improving immunotherapy strategies in patients with advanced ovarian cancer.

Abstract 413. ESGO 2020.

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