Prevalence and prognostic value of the programmed cell death-ligand 1 (PD-L1) expression among tumor samples from cervical cancer patients

ABSTRACT

Objectives: This study aimed to investigate the programmed cell death-ligand 1 (PD-L1) expression in a cohort of cervical cancer (CC) patients evaluating its prognostic significance.

Methods: All patients diagnosed at Brazilian National Cancer Institute (INCA), in 2011, with invasive CC, squamous cell carcinoma (SCC) or adenocarcinoma (ADC) were retrospectively included. Clinical and treatment data were collected and PD-L1 expression was evaluated according to the percentage of viable tumor cells showing staining. The survival analysis was performed using the Kaplan Meier method.

Results: In total, 152 patients (105 SSC and 47 ADC) were included and the mean age was 52.4 years (±14.4). According to the International Federation of Gynecology and Obstetrics (FIGO) 2009, 84.2% had locally advanced disease (IB2-IVA). PD-L1 expression was considered positive (=1%) in 53.3% of the cases. After adjustment, the multivariable analysis confirmed that SCC (p=0.026) and tumor size >4cm (p=0.023) were independently associated with PD-L1 expression. There were no significant differences in disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS) comparing the subgroups with distinct PD-L1 expression.

Conclusion: In this cohort, PD-L1 expression was not associated with DFS, DSS and OS.

RESUMO

Objetivos: Este estudo teve como objetivo investigar a expressão do ligante de morte celular programada 1 (PD-L1) em uma coorte de pacientes com câncer do colo do útero (CC) avaliando sua significância prognóstica.

Métodos: Todos os pacientes diagnosticados no Instituto Nacional do Câncer (INCA), em 2011, com CC invasivo, carcinoma espinocelular (CEC) ou adenocarcinoma (CDA) foram incluídos retrospectivamente. Os dados clínicos e de tratamento foram coletados e a expressão de PD-L1 foi avaliada de acordo com a porcentagem de células tumorais viáveis mostrando coloração. A análise de sobrevida foi realizada pelo método de Kaplan Meier.

Resultados: No total, foram incluídos 152 pacientes (105 CEC e 47 CDA) e a média de idade foi de 52,4 anos (±14,4). De acordo com a Federação Internacional de Ginecologia e Obstetrícia (FIGO) 2009, 84,2% apresentavam doença localmente avançada (IB2-IVA). A expressão de PD-L1 foi considerada positiva (=1%) em 53,3% dos casos. Após o ajuste, a análise multivariada confirmou que CEC (p=0,026) e tamanho do tumor >4cm (p=0,023) estavam independentemente associados àexpressão de PD-L1. Não houve diferenças significativas na sobrevida livre de doença (SLD), sobrevida específica da doença (SED) e sobrevida global (SG) comparando os subgrupos com expressão distinta de PD-L1.

Conclusão: Nesta coorte, a expressão de PD-L1 não foi associada a SLD, SED e SG.

Keywords:

Immune checkpoint inhibitors - Uterine cervical neoplasms - Survival

Descritores:

Inibidores do checkpoint imunológico - Neoplasias cervicais uterinas - Sobrevivência

Publication History

Received: 03 November 2021

Accepted: 06 February 2022

Article published online:
09 March 2022

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