Clinicopathological and prognostic value of programmed death ligand-1 (PD-L1) in renal cell carcinoma: a meta-analysis

Abstract

Background: Recently, the association of immunological checkpoint marker programmed death ligand-1 (PD-L1) and the prognosis of various cancers has always been a research hotspot. The objective of this study is to assess the clinical value of PD-L1 as a novel prognostic biomarker of renal cell carcinoma (RCC).

Methods: Medline/PubMed, EMBASE, the Cochrane Library databases and Grey literature were searched up to 30 March 2015 for eligible studies of the association between PD-L1 expression and cancer-specific survival (CSS) in RCC. The risk ratio (RR) and its 95% confidence interval (CI) were calculated from the included studies. Moreover, the odds ratio (OR) was also extracted to evaluate the association between the clinicopathological parameters of participants and PDL1 expression.

Results: Five studies involving 1073 patients were included in the meta-analysis. The pooled results showed that positive/higher PD-L1 expression was a negative predictor for CSS with RR of 2.90 (95% CI: 1.64-5.13; Pheterogeneity. ≤ 0.001). Additionally, increased PD-L1 was found to be significantly associated with large tumor size (OR = 2.28, 95% CI: 1.61-3.23; Pheterogeneity. = 0.645), high TNM stage (OR = 4.37, 95% CI: 2.99-6.39; Pheterogeneity. = 0.676), poor nuclear grade (OR = 7.58, 95% CI: 5.26-10.92; Pheterogeneity. = 0.203) and present tumor necrosis (OR = 6.77, 95% CI: 4.73-9.71; Pheterogeneity. = 0.111) in renal cell carcinoma patients.

Conclusion: The meta-analysis suggested that PD-L1 could act as a significant biomarker in the worse prognosis and adverse clinicopathologic features of renal cell carcinoma.

Keywords: PD-L1; meta-analysis; prognosis; renal cell carcinoma.

Figures

Figure 1

PRISMA flow chart of the literature search.

Figure 2

Forest plots of studies evaluating risk ratios (RRs) of PD-L1 for cancer specific survival.

Figure 3

Forest plots of studies evaluating the association between PD-L1 and clinical parameters in renal cell carcinoma. A. Tumor size (≥ 5 cm vs.

Figure 4

Effect of individual studies on the pooled RRs for PD-L1 and CSS of patients.

Figure 5

Begg’s funnel plots for all of the included studies reported with CSS.