• Lin Zhang, Jose R Conejo-Garcia, Dionyssios Katsaros, Phyllis A Gimotty, Marco Massobrio, Giorgia Regnani, Antonis Makrigiannakis, Heidi Gray, Katia Schlienger, Michael N Liebman, Stephen C Rubin, and George Coukos.
• Abramson Family Cancer Research Institute, University of Pennsylvania, Philadelphia 19104, USA.
• N. Engl. J. Med. 2003 Jan 16; 348 (3): 203-13.

BackgroundAlthough tumor-infiltrating T cells have been documented in ovarian carcinoma, a clear association with clinical outcome has not been established.MethodsWe performed immunohistochemical analysis of 186 frozen specimens from advanced-stage ovarian carcinomas to assess the distribution of tumor-infiltrating T cells and conducted outcome analyses. Molecular analyses were performed in some tumors by real-time polymerase chain reaction.ResultsCD3+ tumor-infiltrating T cells were detected within tumor-cell islets (intratumoral T cells) in 102 of the 186 tumors (54.8 percent); they were undetectable in 72 tumors (38.7 percent); the remaining 12 tumors (6.5 percent) could not be evaluated. There were significant differences in the distributions of progression-free survival and overall survival according to the presence or absence of intratumoral T cells (P<0.001 for both comparisons). The five-year overall survival rate was 38.0 percent among patients whose tumors contained T cells and 4.5 percent among patients whose tumors contained no T cells in islets. Significant differences in the distributions of progression-free survival and overall survival according to the presence or absence of intratumoral T cells (P<0.001 for both comparisons) were also seen among 74 patients with a complete clinical response after debulking and platinum-based chemotherapy: the five-year overall survival rate was 73.9 percent among patients whose tumors contained T cells and 11.9 percent among patients whose tumors contained no T cells in islets. The presence of intratumoral T cells independently correlated with delayed recurrence or delayed death in multivariate analysis and was associated with increased expression of interferon-gamma, interleukin-2, and lymphocyte-attracting chemokines within the tumor. The absence of intratumoral T cells was associated with increased levels of vascular endothelial growth factor.ConclusionsThe presence of intratumoral T cells correlates with improved clinical outcome in advanced ovarian carcinoma.Copyright 2003 Massachusetts Medical Society

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