Source: International Congress 2014 – Pathology and prognostic factors of thoracic tumours
Disease area: Thoracic oncology

Abstract

Aim. To assess impact on survival of nutritional status, systemic inflammation, and tumoral immune microenvironment in resected NSLCL.Methods. Clinical, pathological and laboratory parameters of 303 patients treated by surgery for NSCLC were analyzed. Tumoral infiltration by CD8 lymphocytes and mature dendritic cells was assessed.Results. In the whole population, concurrent lung disease, Karnofsky index, ASA class, extent of resection, pathologic stage, and the presence of vascular emboli affected the outcome (all p<0.05). Prealbumin (p=0.0087) and CRP levels (p=0.037), as well as tumoral infiltration by CD8+ lymphocytes (p=0.028) and mature dendritic cells (p=0.0015) predicted survival. At multivariate analysis, prealbumin levels, CD8+ cell count, and disease stage were identified as independent prognostic markers. When taken together, parameters related to systemic inflammation, nutrition and tumoral immune microenvironment allowed a robust prognostic discrimination (p<0.0000001), with patients with undetectable CRP, high (>285 mg/L) prealbumin levels, and high (>96/mm2) CD8+ cell count showing a 5-year survival rate of 80% as compared to 18% in patients with higher CRP levels, lower prealbumin concentration and lower CD8+ cell count. If stage I-II disease were considered alone, the prognostic significance of prealbumin and CRP levels, as well as of infiltrating CD8+ and DC count was even more marked (p=0.00076, 0.0049, 0.00037, and 0.0050, respectively).Conclusion. Our data show that nutrition, systemic inflammation, and tumoral immune cells infiltration are prognostic determinants, and, taken together, may robustly predict outcome.

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Citations should be made in the following way:
M. Alifano, A. Lupo, N. Roche, A. Bobbio, J. F. Regnard, I. Cremer, M. C. Dieu-Nosjean, D. Damotte (Paris, France). Systemic inflammation, nutritional status and tumor immune microenvironment determine outcome in resected non-small cell lung cancer. Eur Respir J 2014; 44: Suppl. 58, 505

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