Evaluation of tumor infiltrating lymphocites (TILs) and survival in patients with resected non-small cell lung cancer

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Background: Due to the prognosis of non-small cell lung cancer (NSCLC), even at initial stages we need to characterise better our patients in order to know their prognosis. The purpose of our study is to find some prognostic factors to help us to choose the best therapeutic approach. We found some data about histology and tumor lymphocytic infiltration. Methods: We followed outcome of 94 patients diagnosed of initial stage NSCLC that underwent surgery in our institution between 2010-2013, for more than 5 years, and related survival with findings in tumor samples. Results: Tumor samples were classified in order to establish 4 variables related to tumor lymphocitic inflltration (TILs, as it was established by Brambilla et al): absent, mild, moderate and intense. 20 (21.3%) patients were considered TILs intense, 36 (38.3%) moderate, 33 (35.1%) mild and 5 absent (5.3%). We found some significative differences in disease free survival (DFS, more favorable for TILs absent group), but none for overall survival (OS). Conclusions: TILs and tumor stage could be part of an immunoscore to classify initial stage NSCLC, this score should be validated in future studies [Table: see text]

Histological features and survival in NSCLC patients treated with surgery with curative intention

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Background: New classification of adenocarcinomas and better typing of histological characteristics of lung tumors leads us to wonder if these histological data could have a prognostic repercussion in the NSCLC who were into curative intent surgery Methods: We followed 95 patients with stage I-III NSCLC underwent surgery in a 4 year period (2010-2013), until August 2016. Most patients were male (82%), smokers (90%, 44% exsmokers and 56% active , median age at diagnosis was 64 years, 47% had a previous COPD, and 52% were diagnosed of NSCLC without any symptom of lung cancer. 79% patients had lobectomy or sleeve resection, and 21% pneumonectomy. 47% patients had adjuvant chemotherapy (CT) Results: We found no significant differences in age of diagnosis between men (64.95 y) and women (58.65 y) (p = 0.066) nor in survival time. Median disease-free survival (DFS) is 15 months and overall survival (OS) is 49 months. If we analyze DFS from surgery to the first relapse, most happen at first 2 years (80%). By stage, OS at 5 years is 73% in stage IA, 58% stage IB, 46% stage IIA, 36% stage IIB, 24% for stage IIIA and 9% in IIIB. We had 49% adenocarcinomas (most frequent, 53%, acinar subtype), and 51% squamous, and we found no significant difference between histologies, nor between subtypes. But there was a significant difference between DFS, favorable for mild lymphoid response (20 months) with respect to moderate or intense response (11 months) Conclusions: We found that we are underusing adjuvant CT. In our group there is no difference in survival for tumor size, linfovascular invasion, histological grade or histology, but we found a better DFS for mild lymphoid response vs moderate-intense pattern. This finding may be related to the antitumor activity of the immune system, and we want to validate it prospectively, and its relationship with subsequent immune therapy response.

[Testicular epidermoid cyst]

OBJECTIVE

Testicular epidermoid cysts are rare and can be clinically misleading with other testicular neoplasms. We describe a case of epidermal cyst of the testis, with the aim to contribute to the clinicopathological knowledge of this entity.

METHODS

A 24-year-old caucasian man presented with a self-detected right testicular mass. Ultrasound features were consistent with solid tumor. He underwent an inguinal radical orchyectomy.

RESULTS

An intraparenchymal cyst measuring 1,4 cm was observed, covered by epidermal epithelium with no other skin components. Adnexal testicular pulp was normal.

CONCLUSIONS

When a preoperative diagnosis is made, a conservative treatment is recommendable, including frozen sections analysis of the cyst and adjacent testicular parenchyma to rule out a coexistent intratubular germ cell neoplasia.