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Updated: May 5, 2026
Evaluation of Tumor-infiltrating Leukocyte Subsets in a Subcutaneous Tumor Model
Published on: April 13, 2015
Tumor-infiltrating lymphocyte scoring improves progression risk prediction in stage II melanoma: A retrospective
George Adigbli1, Benedict Reed2, Bhavika Khera2
1Translational Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom; Department of Plastic Surgery, The Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom; Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, United Kingdom.
Background:
The American Joint Committee on Cancer eighth edition substaging might be suboptimal for predicting melanoma progression. Using it to select stage II patients for adjuvant immunotherapy risks overtreating low-risk stage IIB/IIC patients and undertreating high-risk stage IIA patients. Prognostic capability of tumor-infiltrating lymphocytes (TILs) is unclear in stage II melanoma.
Objective:
To evaluate the American Joint Committee on Cancer eighth edition substaging and TIL scoring as predictors of progression in stage II melanoma.
Methods:
Retrospective cohort study of 366 sentinel lymph node negative stage II melanoma patients from 4 UK hospitals (2004-2017), with long-term follow-up.
Results:
Twenty-three percent of melanomas progressed (median 9.5-year follow-up). Among those, 41.5% were stage IIA, 41.5% IIB, and 17.1% IIC. TIL scoring independently predicted progression risk (brisk vs non-brisk: odds ratio: 0.298, P = .009; absent vs non-brisk: odds ratio: 0.436, P = .049) and progression-free survival. Nonbrisk TILs, present in 80% of progressing tumors, denoted high risk. TIL scoring split patients into high and low risk across substages: stage IIA patients with non-brisk TILs had similar 5-year progression-free survival to stage IIB/IIC patients with absent/brisk TILs.
Limitations:
Retrospective study design and unknown generalizability.
Conclusion:
Stage II melanoma progression is poorly predicted by the American Joint Committee on Cancer eighth edition substage. TIL scoring offers improved risk stratification across substages and could serve as a cost-effective method to better identify patients who may benefit from adjuvant immunotherapies.
