Systematic assessment of tumor necrosis at baseline in cervical cancer - An independent factor associated with poor outcome

• Published in: Human pathology Vol. 143; pp. 62 - 70
• Main Authors: Chouchane-Mlik, Olfa, Oniga, Alexandra, Latouche, Aurélien, Halladjian, Maral, Kleine-Borgmann, Felix B, Gérardy, Jean-Jacques, Mittelbronn, Michel, Kamal, Maud, Scholl, Suzy M
• Format: Journal Article
• Language: English
• Published: United States 01-01-2024
• Subjects: B7-H1 Antigen - analysis; Biomarkers, Tumor - metabolism; CD8-Positive T-Lymphocytes - metabolism; Europe; Female; Humans; Lymphocytes, Tumor-Infiltrating - metabolism; Necrosis; Prognosis; Progression-Free Survival; Uterine Cervical Neoplasms - metabolism; Young Adult; Europe; Tumor mutational burden; Tumor microenvironment; Lymphocytes; Cervical cancer biomarkers; FIGO stage; PD-L1; Macrophages; Tumor necrosis; HPV
• ISSN: 0046-8177; 1532-8392; 1532-8392
• DOI: 10.1016/j.humpath.2023.12.003

Cervical cancer (CC) is a leading challenge in oncology worldwide, with high prevalence and mortality rates in young adults, most prominent in low to middle-income countries with marginal screening facilities. From the prospectively collected BioRAIDS (NCT02428842) cohort of primary squamous CC conducted in 7 European countries, a central pathology review was carried out on 294 patients' tumors. The focus was on identification of tumor-stromal characteristics such as CD8
, CD45
, CD68
staining cells, PD-L1 expression, tumor infiltrating lymphocytes (TILs) together with the degree of tumor necrosis. Both (FIGO-2018) stage (I-II/III-IV) as well as tumor necrosis were highly significantly associated with Progression-free Survival (PFS); with tumor necrosis scoring as most potent independent factor in a multivariable analysis (p < 0.001). Tumor necrosis can be assessed in the very first diagnostic biopsyand our data suggest that this rapid, simple and cost-effective biomarker, should be routinely assessed prior to treatment decisions.