Introduction: Head and neck squamous cell carcinoma is now recognized as an immunosuppressive carcinoma with multiple immune defects contributing to its development as well as its resistance to therapy. Immune cell infiltration into tumors is thought to correlate with improved outcomes. As a result, we planned to evaluate several immune markers and compare this with clinical outcomes in laryngeal carcinoma.
Methods: Tissue microarrays were created from the tumor core samples of patients who underwent salvage laryngectomy. TMAs were stained for the presence CD8 (cytotoxic T cells), CD4 (helper T cells), p16, and PDL1. p16 status and PDL1 positivity were measured, and CD8 and CD4 positive tumor infiltrating lymphocytes were measured. Cox models were used to evaluate for associations with patient outcomes.
Results: Elevated levels of CD8 positive tumor infiltrating lymphocytes were associated with improved disease specific survival (p=0.023) and disease free survival (p=0.045). Overall survival was not found to be significant (p=0.163). CD4 positive tumor infiltrating lymphocytes, p16 positivity, and PDL1 positivity were not found to be significant in this patient population.
Conclusions: These findings suggest that CD8 positive tumor infiltrating lymphocytes are a significant prognostic factor for HNSCC. However, other immune markers including CD4, p16, and PDL1 status were not found to be statistically significant in salvage larynx patients. Further validation and evaluation of other immune markers in the salvage larynx population should be performed.