Association of Tumor-Infiltrating Lymphocytes and Inflammation Status with Survival Outcome in Patients with High-Grade Serous Ovarian Carcinoma.

: Tumor-infiltrating lymphocytes (TILs) and inflammation status are emerging prognostic markers in various cancers, but their significance in high-grade serous ovarian carcinoma (HGSC) remains unclear. Our objective was to evaluate different TIL subtypes and inflammation status in relation to progression-free survival (PFS) in primary HGSC. : CD3/CD4/CD8/PD-1+ stromal TILs (sTILs) and intraepithelial TILs (iTILs) were evaluated by manual assessment and digital image analysis (DIA), following TIL Working Group recommendations. Inflammation status was evaluated through the following scores: systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), CA125, and lactate dehydrogenase (LDH). : CD8 TILs were the most prevalent subtype in both iTILs and sTILs. However, sTILs were significantly more abundant than iTILs ( < 0.001) among all subsets, except for PD-1+ cells. DIA results of TIL assessments were in agreement with manual assessments. High stromal CD3 and CD8 TILs, PIV, CA125, and LDH, were associated with improved PFS. Potential independent prognostic factors for PFS in manual assessment were PIV (HR = 0.32, CI 95% = 0.12-0.82) and CD8 sTILs (HR = 0.30, CI 95% = 0.12-0.79), whereas in DIA assessment they were CD3 sTILs (HR = 0.31, CI 95% = 0.15-0.67), PIV (HR = 0.35, 95% CI 0.13-0.96), and residual disease (HR = 0.21 95% CI 0.08-0.53). : CD3/CD8 sTILs and PIV are promising prognostic indicators in HGSC; however, further research is needed to confirm their clinical utility.