WEDNESDAY, April 2, 2025 -- Tumor-infiltrating lymphocyte (TIL) scoring improves risk stratification in stage II melanomas, according to a study published online March 21 in the Journal of the American Academy of Dermatology.

George Adigbli, M.B.B.S., D.Phil., from the University of Oxford in the United Kingdom, and colleagues examined American Joint Committee on Cancer substaging and TIL scoring as predictors of progression in stage II melanoma. The authors conducted a retrospective cohort study of 366 sentinel lymph node negative (SLN-negative) patients with long-term follow-up from four U.K. hospitals.

The researchers found that at a median follow-up of 9.5 years, 23 percent of melanomas progressed. Of these, 41.5, 41.5, and 17.1 percent were stage IIA, IIB, and IIC, respectively. Progression risk was independently predicted by TIL scoring (nonbrisk versus brisk: odds ratio, 0.298; nonbrisk versus absent: odds ratio, 0.436), as was progression-free survival. Nonbrisk TILs denoted high risk and were present in 80 percent of progressing tumors. Across substages, TIL scoring split patients into high and low risk; similar five-year progression-free survival was seen for stage IIA patients with nonbrisk TILs and stage IIB/IIC patients with absent/brisk TILs.

"Our study demonstrates that TIL scoring, particularly the assessment of TIL function, is a valuable, cost-effective prognostic tool for refining risk stratification in SLN-negative stage II melanoma patients," the authors write. "Amidst the rapid move toward earlier adjuvant immunotherapies, this marks a meaningful step forward in personalized cancer care."