Prognostic Significance of Tumor Infiltrating Lymphocytes in Melanoma

The prognostic significance of tumor infiltrating lymphocyte (TIL) response in cutaneous melanoma is controversial. This analysis of data from a prospective, randomized trial included patients with cutaneous melanoma > or = 1.0 mm Breslow thickness who underwent wide local excision and sentinel l...

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Bibliographic Details
Published in:The American surgeon 2011-02, Vol.77 (2), p.188-192
Main Authors: BURTON, Alison L, ROACH, Brent A, MCMASTERS, Kelly M, MAYS, Michael P, CHEN, Andrea F, GINTER, Brooke A. R, VIERLING, Abbey M, SCOGGINS, Charles R, MARTIN, Robert C. G, STROMBERG, Arnold J, HAGENDOORN, Lee
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Biopsy
Breast cancer
Dermatology
Disease-Free Survival
Female
General aspects
Humans
Lymphocytes
Lymphocytes, Tumor-Infiltrating - immunology
Male
Medical sciences
Melanoma - immunology
Melanoma - mortality
Middle Aged
Multivariate Analysis
Prognosis
Prospective Studies
Skin Neoplasms - immunology
Skin Neoplasms - mortality
Studies
Tumors of the skin and soft tissue. Premalignant lesions
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Summary:The prognostic significance of tumor infiltrating lymphocyte (TIL) response in cutaneous melanoma is controversial. This analysis of data from a prospective, randomized trial included patients with cutaneous melanoma > or = 1.0 mm Breslow thickness who underwent wide local excision and sentinel lymph node (SLN) biopsy. Univariate and multivariate analyses were performed to determine factors associated with TIL response, disease-free survival (DFS), and overall survival (OS). A total of 515 patients were included; TIL response was classified as "brisk" (n = 100; 19.4%) or "non-brisk" (n = 415; 80.6%). Patients in the nonbrisk TIL group were more likely to have tumor-positive SLN (17.6% vs 7%; P = 0.0087). On multivariate analysis, nonbrisk TIL response, increased tumor thickness, and ulceration were significant independent predictors of tumor-positive SLN. By Kaplan-Meier analysis, 5-year DFS rate was 91 per cent for those with a brisk TIL response compared with 86 per cent in the nonbrisk group (P = 0.41). The 5-year OS rates were 95 per cent versus 84 per cent in the brisk versus nonbrisk TIL groups, respectively (P = 0.0083). However, on multivariate analysis, TIL response was not a significant independent factor predicting DFS or OS. TIL response is a significant predictor of SLN metastasis but is not a major predictor of DFS or OS.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481107700219