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Eriksen AC, Sørensen FB, Lindebjerg J, Hager H, dePont Christensen R, Kjær-Frifeldt S, Hansen TF. Programmed Death Ligand-1 expression in stage II colon cancer - experiences from a nationwide populationbased cohort. BMC Cancer 2019; 19:142. [PMID: 30755167 DOI: 10.1186/s12885-019-5345-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 02/01/2019] [Indexed: 02/07/2023] Open
Abstract
Background Patients suffering from high risk stage II colon cancer (CC) may benefit from adjuvant onco-therapy, but additional prognostic markers are needed for better treatment stratification. We investigated the prognostic value of Programmed Death Ligand-1 (PD-L1) in a true population-based cohort of patients with stage II CC. Methods PD-L1 expression on tumour cells was evaluated by immunohistochemistry in 572 colon cancers. Whole sections from tumour blocks representing the deepest invasive front of the primary tumour were used for analysis. A cut-off of 5% positivity was used for dichotomizing the data. The prognostic value was investigated in Cox proportional hazard models for recurrence-free survival (RFS) and overall survival (OS). Results Overall, 6% of the tumours were classified as high PD-L1. High PD-L1 was related to female gender (p = 0.028), high malignancy grade (< 0.001), right side localization (p < 0.001) and microsatellite instability (MSI) (p < 0.001). Thirty-one (18%) of the MSI and 4 (1%) of the microsatellite stable tumours were classified as high PD-L1, respectively. PD-L1 expression provided no prognostic value as a single marker. In patients with MSI tumours, high PD-L1 expression had no significant impact regarding OS or RFS. Conclusions PD-L1 expression in tumour cells of stage II CC did not provide any prognostic impact, neither in the entire population-based cohort nor in the group of MSI patients. Additional investigations of the immunogenic microenvironment are needed for evaluating the prognostic information in CC.
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Eriksen AC, Sørensen FB, Lindebjerg J, Hager H, dePont Christensen R, Kjær-Frifeldt S, Hansen TF. The prognostic value of tumour stroma ratio and tumour budding in stage II colon cancer. A nationwide population-based study. Int J Colorectal Dis 2018; 33:1115-1124. [PMID: 29785462 PMCID: PMC6060800 DOI: 10.1007/s00384-018-3076-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 02/04/2023]
Abstract
PURPOSE High-risk patients with stage II colon cancer (CC) may benefit from adjuvant chemotherapy, but additional prognostic markers are needed for better stratification. We investigated the prognostic value of tumour stroma ratio (TSR) and tumour budding (TB). METHODS A nationwide population-based cohort of 573 patients with stage II CC was included. TSR was scored on hematoxylin and eosin sections as low TSR (> 50% stroma) and high TSR (≤ 50% stroma). TB was evaluated in hotspots on pan-cytokeratin stained sections in 10 high power fields (HPF) at the invasive front and classified by the mean number of buds per HPF as high grade budding (≥ 10 buds) or low-grade budding (< 10 buds). The prognostic value was investigated in Cox proportional hazard models for recurrence-free survival (RFS) and overall survival (OS). RESULTS Low TSR was associated with worse RFS (HR = 1.342 (95% CI 1.006-1.791), p = 0.045) and OS (HR = 1.376 (95% CI 1.016-1.862), p = 0.039). Furthermore, an association was found between low TSR and microsatellite stabile tumours (p < 0.001). The mean number of buds per HPF was associated to TSR with increasing number of buds related to a lower TSR (p = 0.026). No statistically significant prognostic impact of TB regarding OS or RFS was detected. CONCLUSIONS TSR provided valuable prognostic information, and adding TSR to the current risk stratification may contribute to better patient selection. The estimates of TSR and TB were found to be associated, but no prognostic value of TB was documented.
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Affiliation(s)
- Ann Christina Eriksen
- Danish Colorectal Cancer Center South, Vejle Hospital, Vejle, Denmark ,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark ,Department of Pathology, Lillebaelt Hospital, Beriderbakken 4, DK-7100 Vejle, Denmark
| | - Flemming B. Sørensen
- Danish Colorectal Cancer Center South, Vejle Hospital, Vejle, Denmark ,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark ,Department of Clinical Medicine, University Institute of Pathology, Aarhus University Hospital, University of Aarhus, Aarhus, Denmark
| | - Jan Lindebjerg
- Danish Colorectal Cancer Center South, Vejle Hospital, Vejle, Denmark ,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark ,Danish Colorectal Cancer Group (DCCG), Hvidovre, Denmark
| | - Henrik Hager
- Danish Colorectal Cancer Center South, Vejle Hospital, Vejle, Denmark ,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | | | - Torben F. Hansen
- Danish Colorectal Cancer Center South, Vejle Hospital, Vejle, Denmark ,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark ,Danish Colorectal Cancer Group (DCCG), Hvidovre, Denmark
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