Prognostic significance of tumor-infiltrating lymphocytes for patients with colorectal cancer

Arch Surg. 2012 Apr;147(4):366-72. doi: 10.1001/archsurg.2012.35.


Objective: To evaluate the prognostic significance of tumor-infiltrating lymphocytes (TILs) in patients with colorectal cancer.

Design: A retrospective review of prospectively collected data.

Setting: Tertiary care hospital.

Patients: A total of 546 patients who underwent curative surgery for primary nonmetastatic colorectal cancers from May 1, 2004, through December 31, 2007.

Main outcome measures: The prognostic value of macroscopic ulceration, tumor border configuration, and TILs at the invasive margin was assessed.

Results: The low TIL group was significantly correlated with a poorly differentiated status and perineural invasion. During the median 54-month follow-up period, the low TIL group had significantly lower 5-year overall survival and disease-free survival rates than the high TIL group of patients with stage III colorectal cancer (P = .005 and P = .03, respectively); however, for patients with stage I and II cancers, the survival rates did not differ between the 2 groups. The 5-year overall survival and 5-year disease-free survival rates were significantly different between the high and low TIL groups of patients with rectal cancer (P = .003 and P = .01, respectively). The multivariate analysis confirmed that the TIL grade was significantly and independently associated with a worse prognosis for overall survival but not for disease-free survival.

Conclusions: An inflammatory cell reaction at the tumor invasive border is considered a useful predictor of survival after colorectal cancer surgery, particularly for patients with stage III disease or rectal cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Chi-Square Distribution
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery
  • Female
  • Humans
  • Lymphocytes, Tumor-Infiltrating / pathology*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Survival Rate