2022-RA-654-ESGO Identification of clinicopathologic factors related to PD-1/PD-L1 expressionand > forsurvival analysis in endometrial cancer patients. (20th October 2022)

• Record Type: Journal Article
• Authors: Kim, Yeorae
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 2
• Page Start: A102
• Page End: A103
• Publication Date: 2022-10-20
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-ESGO.224
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction/Background: We investigated the relationship of programmed death-ligand 1(PD-L1) expression with clinicopathologic characteristics, to identify clinical significance of PD-1/PD-L1 immunotherapy in endometrial cancer. Methodology: Total 232 patients with endometrial cancer were selected who underwent medical or surgical treatment in Seoul National University Bundang Hospital from May 2003 to March 2022. Paraffin-embedded tissues were immunohistochemically stained with PD-L1 antibody, p53 antibody and antibodies against MMR proteins. We regarded PD-L1 positivity as a 1 or more of Combined Positive Score (CPS). The correlation of PD-L1 expression, clinicopathologic factors and survival outcomes were statistically analyzed with SPSS ver.25.0. Results: In comparison of clinicopathologic factors, PD-L1 positivity was related to deep invasion depth (24.4% vs. 35.6%), high grade (19.1% vs. 37.0%) and LVSI positive (25.6% vs. 39.7%) between PD-L1 negative and PD-L1 positive group. With MSI test, MSI-H was correlated with PD-L1 positivity (44.0% vs. 85.7%, p value=0.005). When two MMR minor proteins (MSH6 and PMS2) are proficient, PD-L1 tends to be positive (p value= 0.006/0.002). PD-L1 expression was detected in 31.5% of all patients. Median follow-up duration was 13.5 months (range: 0.3 to 92.5 months). 31(13.4%) patients' recurrence and 5 (2.2%) patients' death were noted. PD-L1 was related to low recurrence rate (p value=0.005). In addition, PD-L1 negative group shows better progression free survival (PFS) than PD-L1 positive group (5 yr-PFS, 94.1% vs 86.3%, p value=0.139). However, neither PFS nor Overall survival (OS) (p value=0.596) was statistically significant. Even though PD-L1 showed no solid statistical significance, PD-L1 was significantly correlated to poor prognosis. In addition, histologically other than endometrioid type group (p=0.008) and lymphovascular invasion (LVSI) positive groups (p=0.023) are poor prognostic factors for survival also. Conclusion: PD-L1 is an independent poor prognostic factor in endometrial cancer recurrence. Patients with higher grade and LVSI positive could be rational candidates for anti PD-1/PD-L1 immunotherapy in endometrial cancer.