Objective:

To investigate whether an integrated immune-inflammatory phenotype combining stromal tumor-infiltrating lymphocytes (TILs) and the systemic immune-inflammation index (SII) could improve recurrence-free survival (RFS) stratification after surgery in cervical cancer patients, thereby enhancing prognostic accuracy beyond conventional factors.

Approach:

Key Findings:

• 119 patients experienced an RFS event during follow-up, highlighting the clinical relevance of the findings.
• Significant RFS differences were observed according to TIL category, SII category, and integrated phenotype, suggesting potential for tailored treatment strategies.
• FIGO IIIC disease, positive margin status, and poor integrated phenotype were independently associated with worse RFS, indicating critical factors for risk assessment.
• LASSO-Cox achieved the highest C-index (0.782) and best discrimination at 24 and 36 months, supporting its use in clinical decision-making.
• Immunohistochemical validation indicated that the favorable phenotype was characterized by higher CD8+ cell density and lower CD163+ cell density, reinforcing the importance of immune profiling.

Interpretation:

An integrated immune-inflammatory phenotype combining stromal TILs and SII was independently associated with postoperative recurrence risk in cervical cancer and corresponded to distinct tissue immune states.

Limitations:

• The study is retrospective and may be subject to selection bias, and potential confounding factors were not fully accounted for.
• Findings may not be generalizable to all cervical cancer populations due to the specific cohort studied.

Conclusion:

The integrated immune-inflammatory phenotype may provide a practical framework for recurrence risk stratification, while LASSO-Cox and RSF offer complementary prognostic perspectives, potentially guiding personalized treatment approaches.

Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.