A1 Journal article (refereed)
The impact of preoperative treatments on the immune environment of rectal cancer (2024)


Wirta, E., Elomaa, H., Ahtiainen, M., Hyöty, M., Seppälä, T. T., Kuopio, T., Böhm, J., Mecklin, J., & Väyrynen, J. P. (2024). The impact of preoperative treatments on the immune environment of rectal cancer. Apmis, Early View. https://doi.org/10.1111/apm.13467


JYU authors or editors


Publication details

All authors or editorsWirta, Erkki‐Ville; Elomaa, Hanna; Ahtiainen, Maarit; Hyöty, Marja; Seppälä, Toni T.; Kuopio, Teijo; Böhm, Jan; Mecklin, Jukka‐Pekka; Väyrynen, Juha P.

Journal or seriesApmis

ISSN0903-4641

eISSN1600-0463

Publication year2024

Publication date10/09/2024

VolumeEarly View

PublisherWiley-Blackwell

Publication countryUnited States

Publication languageEnglish

DOIhttps://doi.org/10.1111/apm.13467

Publication open accessOpenly available

Publication channel open accessPartially open access channel

Publication is parallel published (JYX)https://jyx.jyu.fi/handle/123456789/97056


Abstract

To improve local disease control, the use of preoperative radiotherapy either alone or combined with chemotherapy has become standard practice in rectal cancer, but it is unclear how these treatments modify the antitumoral immune response. We aimed to evaluate tumor histopathologic features and the prognostic effect of host immune response in rectal cancer with variable treatment modalities. Ninety-five rectal cancers with short-course radiotherapy (SRT), 97 with long-course chemoradiotherapy (CRT), and 154 without preoperative treatments, were evaluated for histopathologic features including Crohn's-like reaction (CLR). CD3+ and CD8+ immunohistochemistry and tumor cells were analyzed from tumor tissue microarray samples to calculate T-cell densities and G-cross function values to estimate cancer cell–T-cell co-localization (proximity score). We found that lymphocyte densities were diminished after SRT, but CLR was scarcer after CRT. Proximity score and CLR density were prognostic for survival in cancer without preoperative treatments and could be combined into an enhanced prognostic score (immune grade). In the irradiated tumors, CLR density remained prognostic while the impact of T-cell infiltration was insufficient alone. In multivariable analysis, the immune grade proved to be an independent prognostic factor for survival. In conclusion, the immune contexture of rectal cancer harbors prognostic significance even after preoperative radiotherapy.


Keywordscancerous diseasesradiotherapytumourspreoperative care

Free keywordstumor-infiltrating lymphocytes; Crohn’s-like reaction; short-course radiotherapy; chemo radiotherapy; tumor regression


Contributing organizations


Ministry reportingYes

VIRTA submission year2024

Preliminary JUFO rating1


Last updated on 2024-14-10 at 15:10