Tumor-Infiltrating Lymphocyte Grade in Primary Melanomas Is Independently Associated With Melanoma-Specific Survival in the Population-Based Genes, Environment and Melanoma Study
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Published:2013-11-20
Issue:33
Volume:31
Page:4252-4259
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ISSN:0732-183X
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Container-title:Journal of Clinical Oncology
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language:en
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Short-container-title:JCO
Author:
Thomas Nancy E.1, Busam Klaus J.1, From Lynn1, Kricker Anne1, Armstrong Bruce K.1, Anton-Culver Hoda1, Gruber Stephen B.1, Gallagher Richard P.1, Zanetti Roberto1, Rosso Stefano1, Dwyer Terence1, Venn Alison1, Kanetsky Peter A.1, Groben Pamela A.1, Hao Honglin1, Orlow Irene1, Reiner Anne S.1, Luo Li1, Paine Susan1, Ollila David W.1, Wilcox Homer1, Begg Colin B.1, Berwick Marianne1
Affiliation:
1. Nancy E. Thomas, Pamela A. Groben, Honglin Hao, and David W. Ollila, University of North Carolina, Chapel Hill, NC; Klaus J. Busam, Irene Orlow, Anne S. Reiner, and Colin B. Begg, Memorial Sloan-Kettering Cancer Center, New York, NY; Lynn From, Women's College Hospital, Toronto, Ontario; Richard P. Gallagher, British Columbia Cancer Research Centre, Vancouver, British Columbia, Canada; Anne Kricker and Bruce K. Armstrong, The University of Sydney, Sydney, New South Wales; Alison Venn, Menzies Research...
Abstract
Purpose Although most hospital-based studies suggest more favorable survival with tumor-infiltrating lymphocytes (TILs) present in primary melanomas, it is uncertain whether TILs provide prognostic information beyond existing melanoma staging definitions. We addressed the issue in an international population-based study of patients with single and multiple primary melanomas. Patients and Methods On the basis of the Genes, Environment and Melanoma (GEM) study, we conducted follow-up of 2,845 patients diagnosed from 1998 to 2003 with 3,330 invasive primary melanomas centrally reviewed for TIL grade (absent, nonbrisk, or brisk). The odds of TIL grades associated with clinicopathologic features and survival by TIL grade were examined. Results Independent predictors (P < .05) for nonbrisk TIL grade were site, histologic subtype, and Breslow thickness, and for brisk TIL grade, they were age, site, Breslow thickness, and radial growth phase. Nonbrisk and brisk TIL grades were each associated with lower American Joint Committee on Cancer (AJCC) tumor stage compared with TIL absence (Ptrend < .001). Death as a result of melanoma was 30% less with nonbrisk TIL grade (hazard ratio [HR], 0.7; 95% CI, 0.5 to 1.0) and 50% less with brisk TIL grade (HR, 0.5; 95% CI, 0.3 to 0.9) relative to TIL absence, adjusted for age, sex, site, and AJCC tumor stage. Conclusion At the population level, higher TIL grade of primary melanoma is associated with a lower risk of death as a result of melanoma independently of tumor characteristics currently used for AJCC tumor stage. We conclude that TIL grade deserves further prospective investigation to determine whether it should be included in future AJCC staging revisions.
Publisher
American Society of Clinical Oncology (ASCO)
Subject
Cancer Research,Oncology
Cited by
224 articles.
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