Research Paper Advance Articles

Programmed cell death-ligand 1 expression predicts poor treatment response and prognostic value in esophageal squamous cell carcinoma patients without esophagectomy

Fang Zhang1, , Xiuyuan Zhu2, , Qi Zhang3, , Ping Zhou3, , Liang Hao1, ,

  • 1 Department of Radiation Oncology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 26400, Shandong, China
  • 2 Department of Anesthesiology, The First Hospital of Zibo, Zibo 255200, Shandong, China
  • 3 Department of Pathology, The First Hospital of Zibo, Zibo 255200, Shandong, China

Received: March 4, 2021       Accepted: July 8, 2021       Published: July 22, 2021      

https://doi.org/10.18632/aging.203326
How to Cite

Copyright: © 2021 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Research on association between programmed cell death ligand 1 (PD-L1) expression in cancer cells and prognosis of esophageal squamous cell carcinoma (ESCC) has been controversial and has focused on patients with surgical resection. We aimed to investigate impact of PD-L1 on treatment response and prognostic value in ESCC and analyze which subset of patients may benefit from immunotherapy. The PD-L1 expression was evaluated by immunohistochemical analysis in all patients. Stratification analysis was performed according to whether surgery was performed. There were no significant correlations between PD-L1 expression with 3-year overall survival (OS) and progression-free survival (PFS) in 81 ESCC patients. Then stratification analysis was performed. Among these 44 patients without surgery, disease control rate (DCR) in negative PD-L1 expression group (78%) was significantly better than those (42%) in positive PD-L1 expression group (P = 0.032). There were no significant correlations between PD-L1 expression with 3-year OS and PFS in 37 ESCC patients receiving surgery. However, in 44 ESCC patients without surgery, the Kaplan-Meier method showed that 3-year OS and PFS in negative PD-L1 expression group were significantly better than those in positive PD-L1 expression group. In Cox univariate and multivariate model, PD-L1 was an independent prognosticator for inferior OS (p = 0.011; p = 0.017). Our research revealed prognostic role of PD-L1 expression in cancer cells may be variable in different treatment methods. Consequently, PD-L1 may serve as an independent prognostic factor and provide a theoretical basis for combining conventional therapy with immunotherapy targeting PD-L1 to achieve better treatment outcome in ESCC patients without esophagectomy.

Abbreviations

CI: Confidence Interval; DCR: Disease Control Rate; EC: Esophageal Cancer; ESCC: Esophageal Squamous Cell Carcinoma; HR: Hazard Ratio; IHC: Immunohistochemical; OS: Overall Survival; PD-1: Programmed Cell Death-1; PD-L1: Programmed Cell Death Ligand 1; PFS: Progression-Free Survival.