MP27-02 PROGNOSTIC ROLE OF PROGRAMMED CELL DEATH PROTEIN 1 EXPRESSION IN SURGICALLY TREATED PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA.

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II1 Apr 2016MP27-02 PROGNOSTIC ROLE OF PROGRAMMED CELL DEATH PROTEIN 1 EXPRESSION IN SURGICALLY TREATED PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA. Nozomi Hayakawa, Eiji Kikuchi, Shuji Mikami, Kazuhiro Matsumoto, Keishiro Fukumoto, Takeo Kosaka, Ryuichi Mizuno, Akira Miyajima, and Mototsugu Oya Nozomi HayakawaNozomi Hayakawa More articles by this author , Eiji KikuchiEiji Kikuchi More articles by this author , Shuji MikamiShuji Mikami More articles by this author , Kazuhiro MatsumotoKazuhiro Matsumoto More articles by this author , Keishiro FukumotoKeishiro Fukumoto More articles by this author , Takeo KosakaTakeo Kosaka More articles by this author , Ryuichi MizunoRyuichi Mizuno More articles by this author , Akira MiyajimaAkira Miyajima More articles by this author , and Mototsugu OyaMototsugu Oya More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1033AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Programmed cell death protein (PD-1) expressed on active T cells, and its ligand PD-L1 expressed on the surface of cancer cells, complementarily down-regulate T cell activation and are related to immune tolerance. A close association between PD-1 expression and poor prognosis has been reported in several cancers, however, in upper tract urothelial carcinoma (UTUC) the rule of PD-1 expression on clinical outcome have not been investigated. METHODS The protein expression of PD-1 was evaluated by immunohistochemistry and the relationship with clinicopathological features was investigated in surgical specimens obtained from 133 patients who had been surgically treated for UTUC. At a magnification of 200x, PD-1 protein expression was estimated and the positive cells was graded as weak (0-10 cells) and strong (>10 cells). The protein expression of PD-1 was evaluated in the most invasive part of the cancer with tumor periphery and inside separately. RESULTS In regard to tumor periphery, 51 patients (38.3%) had strong PD-1 staining and 82 patients (61.7%) had weak PD-1 staining. In tumor inside, 30 patients (22.6%) had strong PD-1 staining and 103 patients (77.4%) had weak PD-1 staining. Patients with strong PD-1 staining in tumor periphery had a higher incidence of tumor grade G3 (p<0.001), ≥T2 tumor (p=0.001) and lymphovascular invasion (LVI) positive (p=0.015). The 5-year metastatic-free survival (MFS) and caner-specific survival (CSS) in patients with strong PD-1 staining in tumor periphery was 62.4% and 67.3%, respectively, which were significantly lower than those in their counterparts (80.8%, p=0.016 and 87.2%, p=0.003, respectively). Patients with strong PD-1 staining in tumor inside had a higher incidence of tumor grade G3 (p=0.024). The 5-year MFS and CSS in patients with strong PD-1 staining in tumor inside was 55.3% and 73.4%, respectively, which were significantly lower than those in their counterparts (89.4%, p=0.001 and 84.1%, p<0.001, respectively). Strong PD-1 staining in tumor inside but not in tumor periphery was an independent predictor for MFS (p=0.001) and CSS (p=0.004) in addition to LVI positive. CONCLUSIONS PD-1 expression, especially in tumor inside, may be a novel indicator for identifying a worse prognosis in UTUC patients who undergo radical nephroureterectomy. Targeting therapy against PD-1 might be a promising therapeutic modality for UTUC. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e362 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Nozomi Hayakawa More articles by this author Eiji Kikuchi More articles by this author Shuji Mikami More articles by this author Kazuhiro Matsumoto More articles by this author Keishiro Fukumoto More articles by this author Takeo Kosaka More articles by this author Ryuichi Mizuno More articles by this author Akira Miyajima More articles by this author Mototsugu Oya More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...