We aimed to evaluate the prognostic role of programmed-death receptor ligand (PD-L1) in a multinational cohort of patients with localized renal cell carcinoma (RCC).
Formalin-fixed paraffin-embedded blocks of 1017 patients from the Latin American Renal Cancer Group were analyzed. Tissue microarrays were immunostained for PD-L1 using a commercially available monoclonal antibody. Expression of PD-L1 in ⩾5% tumor cells was considered positive. PD-1 expression in immune cells was also assessed. All cases were reviewed twice based on antibody expression and compared with a positive control. Cox proportional hazard regression models were used to identify predictors of recurrence-free survival (RFS) and overall survival (OS).
A total of 738 cases with complete follow up met criteria. Median age was 57 [interquartile range (IQR): 49-64] years, and median follow up was 34 (IQR: 15-62.9) months. Median tumor size was 5 cm (IQR: 3.0-7.5 cm). Approximately 8.2% and 7.6% of tumors were PD-L1 and programmed cell-death 1 (PD-1) positive, respectively. PD-L1 and PD-1 positivity were significantly associated with higher tumor stage (both p < 0.001), and presence of tumor necrosis and lymphovascular multivariable analyses; PD-L1 positivity was found as a predictor of worse RFS [hazard ratio (HR) = 2.08, p = 0.05] and OS (HR = 2.61, p = 0.02).
PD-L1 positivity was significantly associated with worse outcomes for patients with localized RCC at intermediate follow up. This marker may help stratify patients for stricter surveillance after surgical treatment and provide a basis for checkpoint-inhibitor therapy in the adjuvant setting.
Therapeutic advances in urology. 2019 Oct 13*** epublish ***
Juan Chipollini, Walter Henriques da Costa, Isabela Werneck da Cunha, Felipe de Almeida E Paula, Paulo Guilherme O Salles, Mounsif Azizi, Philippe E Spiess, Diego Abreu, Stênio de Cássio Zequi
Department of Surgery, The University of Arizona College of Medicine, 1501 North Campbell Avenue, PO Box 245077, Tucson AZ 85724-5077, USA., Division of Urology, AC Camargo Cancer Center, São Paulo, Brazil., Serviço de Urologistas, Hospital do Câncer de Presidente Prudente, São Paulo, Brazil., Division of Pathology, Instituto Mario Penna and Biocor Instituto, Belo Horizonte, Brazil., Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA., Servicio de Urología, Hospital Pasteur, Montevideo, Uruguay.