ArticleJournal of gastrointestinal oncology2025
Prognostic role of tertiary lymphatic structures and their modulation by adjuvant FOLFOX in stage III colon cancer: a retrospective cohort study.
Article in Journal of gastrointestinal oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Spatial distribution analysis of tertiary lymphoid structures in esophageal squamous cell carcinoma predicts patient survival and response to neoadjuvant chemo-immunotherapy.Journal of translational medicine · 2026Article
- The Role of Tumor-Infiltrating B Lymphocytes in Colorectal Cancer Patients: A Systematic Review of Immune Landscape Evolution.Cancers · 2025Review
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8 authors.
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Abstract
Background: Stage III colon cancer (CC) presents a critical therapeutic challenge due to its high recurrence risk. Identifying robust prognostic biomarkers to guide adjuvant therapy decisions is urgently needed in clinical practice. Tertiary lymphoid structures (TLSs), as immune aggregates within the tumor microenvironment, have emerged as potential indicators of immunological activity and treatment response. The objective of this study is to evaluate the role of TLSs in stage III CC, focusing on their potential as prognostic markers and their influence on patient outcomes, particularly in relation to chemotherapy response. Methods: This retrospective cohort study enrolled 613 patients with pathologically confirmed stage III CC from two cohorts: 374 from Harbin Medical University and 239 from The Cancer Genome Atlas Colon Adenocarcinoma (TCGA-COAD) external validation cohort. Overall survival (OS) was the primary outcome, with a median follow-up period of 62 months. TLSs were assessed via immunohistochemistry and categorized by density and location [intratumoral (T score), peritumoral (P score)]. Prognostic significance was evaluated using multivariate Cox regression. A murine model was used to assess the immunomodulatory effects of folinic acid, oxaliplatin, and 5-fluorouracil (FOLFOX) chemotherapy on TLS formation. Results: TLSs were present in 54.0% and 50.2% of patients in Cohorts 1 and 2, respectively. TLSs enriched with CD8 Conclusions: TLSs serve as a reliable, independent prognostic biomarker in stage III CC. Their spatial distribution carries distinct prognostic implications, and FOLFOX-induced TLS formation suggests a dual role in cytotoxicity and immune activation. Incorporating TLS assessment into clinical workflows may improve risk stratification and guide personalized treatment, especially in designing immunochemotherapy strategies.
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