title: Tumour-infiltrating lymphocyte scores effectively stratify outcomes over and above p16 post chemo-radiotherapy in anal cancer.
abstract: BACKGROUND
  The majority (90%) of anal cancers are human papillomavirus (HPV)-driven, identified using immunochemistry for p16. Compared with HPV- patients, those with HPV+ disease generally show improved survival, although relapse rates around 25% indicate a need for further stratification of this group.
  
  
  METHODS
  Using two cohorts of anal cancer, previously characterised for p16, we assessed the prognostic value of tumour-infiltrating lymphocytes (TILs).
  
  
  RESULTS
  Tumour-infiltrating lymphocyte scores were used to stratify p16+ cases, where tumours with absent/low levels of TIL had a relapse-free rate of 63%, as opposed to 92% with high levels of TIL (log rank P=0.006).
  
  
  CONCLUSIONS
  Assessment of TIL adds to p16 status in the prognosis of anal cancer following chemo-radiotherapy and provides evidence of the clinical importance of the immune response.
authors.affiliation: Sussex Cancer Centre, Royal Sussex County Hospital Eastern Road, Brighton, Sussex BN2 5BE, UK.
authors.forename: Duncan C
authors.initials: DC
authors.lastname: Gilbert
authors.affiliation: Department of Oncology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730, Denmark.
authors.forename: Eva
authors.initials: E
authors.lastname: Serup-Hansen
authors.affiliation: Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730, Denmark.
authors.forename: Dorte
authors.initials: D
authors.lastname: Linnemann
authors.affiliation: Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730, Denmark.
authors.forename: Estrid
authors.initials: E
authors.lastname: Høgdall
authors.affiliation: Kent Oncology Centre, Maidstone Hospital, Hermitage Lane, Maidstone, Kent ME16 9QQ, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Bailey
authors.affiliation: Kent Oncology Centre, Maidstone Hospital, Hermitage Lane, Maidstone, Kent ME16 9QQ, UK.
authors.forename: Jeff
authors.initials: J
authors.lastname: Summers
authors.affiliation: Department of Oncology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Havsteen
authors.affiliation: Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK.|Cancer Sciences Unit, University of Southampton, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Thomas
mesh_terms: D001005:Anus Neoplasms / Q000276:immunology / Q000378:metabolism / Q000628:therapy* / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D059248:Chemoradiotherapy; D015331:Cohort Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D008297:Male; D009363:Neoplasm Proteins / Q000378:metabolism*; D030361:Papillomavirus Infections / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D009363:Neoplasm Proteins