MP55-11 MODIFIED IMMUNOSCORE IMPROVES PREDICTION OF SURVIVAL OUTCOMES IN PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive II (MP55)1 Apr 2020MP55-11 MODIFIED IMMUNOSCORE IMPROVES PREDICTION OF SURVIVAL OUTCOMES IN PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR BLADDER CANCER Uwe Bieri*, Buser Lorenz, Marian S. Wettstein, Holger Moch, Karim A. Saba, Tulio Sulser, Thomas Hermanns, and Cédric Poyet Uwe Bieri*Uwe Bieri* More articles by this author , Buser LorenzBuser Lorenz More articles by this author , Marian S. WettsteinMarian S. Wettstein More articles by this author , Holger MochHolger Moch More articles by this author , Karim A. SabaKarim A. Saba More articles by this author , Tulio SulserTulio Sulser More articles by this author , Thomas HermannsThomas Hermanns More articles by this author , and Cédric PoyetCédric Poyet More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000924.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Tumor-Infiltrating Lymphocytes (TIL) has been shown to predict disease outcome in several types of cancers. Immunoscore (IS), known as a prognostic factor in colon and lung cancer, offers a method to quantify TIL. Immune activation is involved in genomic subtypes of BC however, data on IS in BC is scarce. The aim of this study was to evaluate the prognostic value of a modified IS in a cohort of bladder cancer (BC) patients undergoing radical cystectomy (RC). METHODS: Two tissue microarrays (TMAs) containing 159 BC patients (Two tissue cores/patient) who all underwent radical cystectomy were immunohistochemically stained for CD4/CD8/FoxP3 and CD45RO. Automated analysis was performed by digital pathology to detect stained TIL. Output was cumulated, averaged and reported as density (positive count per mm2). The four candidate predictors were explored for normality, extreme values and multicollinearity. Cox proportional hazards regression was used to predict progression free survival (PFS), cancer specific survival (CSS) and overall survival (OS). Patients were stratified as “high IS / favorable risk” and “low IS / unfavorable risk” (cut-off: median of linear predictor). Kaplan-Meier analysis were used to test IS within each American Joint Committee on Cancer (AJCC) stage group for BC. RESULTS: The median age in our cohort was 68 years (range: 44-87) and 77% patients were male. AJCC stage distribution was 31 (19.6%) for 0a/0is/I, 34 (21.5%) for II, 57 (36,1%) for IIIa and 36 (22.8%) for IIIb. Median follow-up time after surgery was 35.8 months. The four candidate predictors were log-transformed and reduced to three (CD8/FoxP3 and CD45RO) due to very strong correlation between CD4 and CD8. By using the modified IS we were able to sub-stratify patients within AJCC stages 0is/0a/I, II and IIIa. PFS, CSS and OS were significantly longer for patients with high IS as compared to low IS (p < 0.05). IS was not prognostic for stage IIIb patients (p > 0.05). CONCLUSIONS: Our study provides evidence that IS is of prognostic value in BC patients undergoing RC. The modified IS was able to stratify patients within AJCC stages. IS might serve as a prognostic marker to guide treatment or follow-up strategies post RC if confirmed in further studies. Since this study was performed on TMAs, the determination of IS on selected areas of whole tumor slides might even reveal more precise and reproducible results. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e842-e842 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Uwe Bieri* More articles by this author Buser Lorenz More articles by this author Marian S. Wettstein More articles by this author Holger Moch More articles by this author Karim A. Saba More articles by this author Tulio Sulser More articles by this author Thomas Hermanns More articles by this author Cédric Poyet More articles by this author Expand All Advertisement PDF downloadLoading ...