Raoul Andre Droeser

Purpose Adrenal tumors are a heterogeneous group of neoplasms that may be hormonally active or inactive. Tumor size is a key factor in evaluating and managing these lesions. Understanding how size impacts hormonal activity, surgical outcomes, and complications can help guide treatment and follow-up. This study investigates the relationship between tumor size, hormonal secretion, and clinical outcomes in adrenal tumors. Methods We retrospectively analyzed data from patients who underwent adrenalectomy between 2007 and 2023 at the University Hospital of Basel. Tumors were categorized by pathology and stratified into three size groups based on histology results. Results A total of 170 patients who underwent adrenalectomy for adrenal tumors were analyzed. The most common adrenal pathologies were Conn`s syndrome followed by pheochromocytoma, Cushing syndrome and incidentalomas. Hormone-producing tumors were present in 61.2% of cases. Larger tumors (> 4 cm) were associated with longer operative times (p = 0.03). When tumor size was analyzed in relation to hormone production, small functional tumors (< 2 cm) were most commonly linked to Conn’s syndrome. Cushing syndrome was most prevalent among patients with tumors measuring between 2.1 and 4 cm. There were no significant differences in perioperative complication rates across the tumor size groups. Conclusion Our results showed that tumor size was associated with both operative complexity and functional status. Larger tumors were linked to longer operative times. Smaller tumors were predominantly associated with Conn`s syndrome, while tumors of intermediate size were most often related to Cushing syndrome. These findings highlight the relevance of tumor size in preoperative planning and functional assessment.

Immune cell infiltration in colorectal cancer effectively predicts clinical outcome. IL22, produced by immune cells, plays an important role in inflammatory bowel disease, but its relevance in colorectal cancer remains unclear. Here, we addressed the prognostic significance of IL22+ cell infiltration in colorectal cancer and its effects on the composition of tumor microenvironment. Tissue microarrays (TMA) were stained with an IL22-specific mAb, and positive immune cells were counted by expert pathologists. Results were correlated with clinicopathologic data and overall survival (OS). Phenotypes of IL22-producing cells were assessed by flow cytometry on cell suspensions from digested specimens. Chemokine production was evaluated in vitro upon colorectal cancer cell exposure to IL22, and culture supernatants were used to assess neutrophil migration in vitro. Evaluation of a testing (n = 425) and a validation TMA (n = 89) revealed that high numbers of IL22 tumor-infiltrating immune cells were associated with improved OS in colorectal cancer. Ex vivo analysis indicated that IL22 was produced by CD4+ and CD8+ polyfunctional T cells, which also produced IL17 and IFNγ. Exposure of colorectal cancer cells to IL22 promoted the release of the neutrophil-recruiting chemokines CXCL1, CXCL2, and CXCL3 and enhanced neutrophil migration in vitro. Combined survival analysis revealed that the favorable prognostic significance of IL22 in colorectal cancer relied on the presence of neutrophils and was enhanced by T-cell infiltration. Altogether, colorectal cancer–infiltrating IL22-producing T cells promoted a favorable clinical outcome by recruiting beneficial neutrophils capable of enhancing T-cell responses.

Immune cell infiltration in colorectal cancer effectively predicts clinical outcome. IL22, produced by immune cells, plays an important role in inflammatory bowel disease, but its relevance in colorectal cancer remains unclear. Here, we addressed the prognostic significance of IL22+ cell infiltration in colorectal cancer and its effects on the composition of tumor microenvironment. Tissue microarrays (TMA) were stained with an IL22-specific mAb, and positive immune cells were counted by expert pathologists. Results were correlated with clinicopathologic data and overall survival (OS). Phenotypes of IL22-producing cells were assessed by flow cytometry on cell suspensions from digested specimens. Chemokine production was evaluated in vitro upon colorectal cancer cell exposure to IL22, and culture supernatants were used to assess neutrophil migration in vitro. Evaluation of a testing (n = 425) and a validation TMA (n = 89) revealed that high numbers of IL22 tumor-infiltrating immune cells were associated with improved OS in colorectal cancer. Ex vivo analysis indicated that IL22 was produced by CD4+ and CD8+ polyfunctional T cells, which also produced IL17 and IFNγ. Exposure of colorectal cancer cells to IL22 promoted the release of the neutrophil-recruiting chemokines CXCL1, CXCL2, and CXCL3 and enhanced neutrophil migration in vitro. Combined survival analysis revealed that the favorable prognostic significance of IL22 in colorectal cancer relied on the presence of neutrophils and was enhanced by T-cell infiltration. Altogether, colorectal cancer–infiltrating IL22-producing T cells promoted a favorable clinical outcome by recruiting beneficial neutrophils capable of enhancing T-cell responses.