Elevated PD-L1 expression predicts poor survival outcomes in patients with cervical cancer

Xiaobin Gu,
Meilian Dong,
Zheyan Liu,
Yin Mi,
Jing Yang,
Zhigang Zhang,
Ke Liu,
Li Jiang,
Yue Zhang,
Shiliang Dong and
Yonggang ShiEmail author

Cancer Cell International201919:146

https://doi.org/10.1186/s12935-019-0861-7

Received: 27 March 2019
Accepted: 13 May 2019
Published: 23 May 2019

Abstract

Background

Programmed cell death ligand 1 (PD-L1) expression has been shown to associate with poor prognosis in a variety of solid tumors. However, the prognostic value of PD-L1 expression in cervical cancer is still controversial. Therefore, we carried a meta-analysis to investigate the prognostic and clinicopathological impact of PD-L1 in cervical cancer.

Methods

A comprehensive literature search in was performed in PubMed, Embase, Web of Science, and Cochrane Library. The correlation between PD-L1 expression and overall survival (OS), progression-free survival (PFS), and clinicopathological features was analyzed by hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI).

Results

Seven studies with 783 patients were included in this meta-analysis. The combined HR and 95% CI of OS was 2.52 (1.09–5.83), p = 0.031. The pooled results for PFS were HR = 2.07, 95% CI = 0.52–8.23, p = 0.302. The results of subgroup analysis showed that PD-L1 was a significant prognostic factor of poor OS in Asian patients (HR = 4.77, 95% CI = 3.02–7.54, p < 0.001) and of poor PFS in Asian patients (HR = 4.78, 95% CI = 1.77–12.91, p = 0.002). However, the pooled results suggested that PD-L1 was not significantly correlated with lymph node metastasis, tumor size, FIGO stage, depth of invasion, lymph-vascular invasion, or age.

Conclusions

The results of this meta-analysis suggest that PD-L1 overexpression is related to poor OS in patients with cervical cancer and poor PFS in Asian patients with cervical cancer. This study also suggests that PD-L1 is a promising prognostic indicator for cervical cancer.