Prognostic Impact of Immunoscore in Pathological Stage III Differentiated Gastric Cancer: A Multicenter Cohort Study...

Area of Science:

• Oncology
• Immunology
• Pathology

Background:

• Assessing the tumor microenvironment as a biomarker in gastric cancer (GC) presents clinical challenges.
• This study investigated the prognostic value of Immunoscore (IS) and programmed death ligand 1/2 (PD-L1/2) expression in GC.
• The goal was to identify GC patients at high risk of recurrence for tailored perioperative treatment.

Purpose of the Study:

• To evaluate the prognostic significance of Immunoscore (IS) and PD-L1/2 expression in gastric cancer (GC).
• To determine if these biomarkers can identify patients requiring intensified perioperative therapy.
• To explore the role of histological subtypes in the prognostic ability of IS and PD-L1/2.

Main Methods:

• A multicenter, retrospective cohort study involving 184 untreated pStage III GC patients.
• Immunohistochemistry and digital pathology (HALO software) were used to analyze IS (CD3+ and CD8+ lymphocytes) and PD-L1/2 expression.
• Statistical analyses, including Cox multivariate analysis, assessed associations between biomarkers, clinicopathological factors, and prognosis (recurrence-free survival and overall survival).

Main Results:

• Neither IS nor PD-L1/2 expression served as a prognostic factor in the overall GC cohort.
• In differentiated-type GC, high IS was significantly associated with better recurrence-free survival (RFS) and overall survival (OS).
• In undifferentiated-type GC, IS did not correlate with RFS or OS. IS was an independent prognostic factor for RFS and OS exclusively in differentiated-type GC.

Conclusions:

• Histological classification is crucial for evaluating the tumor microenvironment's prognostic role in GC.
• Patients with differentiated-type pStage III GC and a low IS signature face a higher recurrence risk.
• These patients may benefit from more intensive perioperative treatment strategies.