The Prognostic Value of the Lymph Node in Oesophageal Adenocarcinoma; Incorporating Clinicopathological and Immunological Profiling.
Noel E DonlonMaria DavernAndrew SheppardRobert PowerFiona O'ConnellAisling B HeeranRoss KingConall HayesAnshul BhardwajJacintha O'SullivanMargaret R DunneNarayanasamy RaviClaire L DonohoeJacintha O'SullivanJohn V ReynoldsJoanne LysaghtPublished in: Cancers (2021)
Response rates to the current gold standards of care for treating oesophageal adenocarcinoma (OAC) remain modest with 15-25% of patients achieving meaningful pathological responses, highlighting the need for novel therapeutic strategies. This study consists of immune, angiogenic, and inflammatory profiling of the tumour microenvironment (TME) and lymph node microenvironment (LNME) in OAC. The prognostic value of nodal involvement and clinicopathological features was compared using a retrospective cohort of OAC patients (n = 702). The expression of inhibitory immune checkpoints by T cells infiltrating tumour-draining lymph nodes (TDLNs) and tumour tissue post-chemo(radio)therapy at surgical resection was assessed by flow cytometry. Nodal metastases is of equal prognostic importance to clinical tumour stage and tumour regression grade (TRG) in OAC. The TME exhibited a greater immuno-suppressive phenotype than the LNME. Our data suggests that blockade of these checkpoints may have a therapeutic rationale for boosting response rates in OAC.
Keyphrases
- lymph node
- end stage renal disease
- neoadjuvant chemotherapy
- newly diagnosed
- chronic kidney disease
- squamous cell carcinoma
- stem cells
- flow cytometry
- healthcare
- sentinel lymph node
- locally advanced
- poor prognosis
- palliative care
- peritoneal dialysis
- single cell
- machine learning
- patient reported outcomes
- mesenchymal stem cells
- data analysis
- deep learning
- quality improvement
- early stage
- replacement therapy