CD8+ lymphocyte intratumoral infiltration as a stage-independent predictor of Merkel cell carcinoma survival: a population-based study

Intratumoral CD8+ lymphocytes (IT-CD8s) have shown promise as a prognostic indicator for Merkel cell carcinoma (MCC). We tested whether IT-CD8s predict survival among a population-based MCC cohort. One hundred thirty-seven MCC cases that had not previously been analyzed for IT-CD8s were studied. Thr...

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Bibliographic Details
Published in:American journal of clinical pathology 2014-10, Vol.142 (4), p.452-458
Main Authors: Paulson, Kelly G, Iyer, Jayasri G, Simonson, William T, Blom, Astrid, Thibodeau, Renee M, Schmidt, Miranda, Pietromonaco, Stephanie, Sokil, Monica, Warton, E Margaret, Asgari, Maryam M, Nghiem, Paul
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Carcinoma, Merkel Cell - immunology
Carcinoma, Merkel Cell - mortality
Carcinoma, Merkel Cell - pathology
CD8-Positive T-Lymphocytes - immunology
Cohort Studies
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Prognosis
Proportional Hazards Models
Prospective Studies
Skin Neoplasms - immunology
Skin Neoplasms - mortality
Skin Neoplasms - pathology
Survival Rate
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Summary:Intratumoral CD8+ lymphocytes (IT-CD8s) have shown promise as a prognostic indicator for Merkel cell carcinoma (MCC). We tested whether IT-CD8s predict survival among a population-based MCC cohort. One hundred thirty-seven MCC cases that had not previously been analyzed for IT-CD8s were studied. Three-year MCC-specific survival rates were 56%, 72%, and 100% for patients with absent (n = 46), low (n = 85), and moderate or strong (n = 6) IT-CD8s, respectively. Increased IT-CD8s were associated with improved MCC-specific survival in a multivariate competing risk-regression analysis including stage, age, and sex (hazard ratio [HR] = 0.5; 95% confidence interval [CI] = 0.3-0.9). Although a similar trend was observed for overall survival, statistical significance was not reached (HR = 0.8; 95% CI = 0.6-1.0), likely because of the high rate of non-MCC deaths among older patients. This study of prospectively captured MCC cases supports the concept that cellular immunity is important in MCC outcome and that CD8+ lymphocyte infiltration adds prognostic information to conventional staging.
ISSN:0002-9173
1943-7722
DOI:10.1309/AJCPIKDZM39CRPNC