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Systematic Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Pharmacol. | doi: 10.3389/fphar.2019.00962

Prognostic and clinicopathological significance of PD-L1 in patients with bladder cancer: a meta-analysis

Lei Zhu1, Jin Sun2, Ling Wang3, Zhigang Li4, Lei Wang1 and  Zhibin Li5*
  • 1First People's Hospital of Shangqiu, China
  • 2The General Hospital of Western Theater Command, China
  • 3Panzhihua Central Hospital, China
  • 4Central Hospital, China National Petroleum Corporation, China
  • 5Shanxi Provincial Cancer Hospital, China

Background: The prognostic role of programmed cell death-ligand 1 (PD-L1) in bladder cancer has been investigated in previous studies, but the results remain inconclusive. Therefore, we carried out a meta-analysis to evaluate the prognostic significance of PD-L1 in patients with bladder cancer.
Methods: The electronic databases PubMed, Embase, Web of Science, and Cochrane Library were searched. The association between PD-L1 expression and survival outcomes and clinicopathological factors were analyzed by hazard ratios (HR) or odds ratios (OR) and 95% confidence intervals (CI).
Results: A total of 11 studies containing 1697 patients were included in the meta-analysis. High PD-L1 expression was associated with poor overall survival (OS) (HR=1.83, 95%CI=1.24-2.71, p=0.002). There was non-significant association between PD-L1 and recurrence-free survival (RFS) (HR= 1.43, 95%CI=0.89-2.29, p=0.134), cancer-specific survival (CSS) (HR=1.51, 95%CI=0.80-2.87, p=0.203), or disease-free survival (DFS) (HR=1.53, 95%CI=0.88-2.65, p=0.13).Furthermore, high PD-L1 was significantly correlated with higher tumor stage (OR=3.9, 95%CI=2.71-5.61, p<0.001) and distant metastasis (OR=2.5, 95%CI=1.22-5.1, p=0.012). While PD-L1 overexpression was not correlated with sex, tumor grade, lymph node status, and multifocality.
Conclusions: The meta-analysis suggested that PD-L1 overexpression could predict worse survival outcomes in bladder cancer. High PD-L1 expression may act as a potential prognostic marker for patients with bladder cancer.

Keywords: Meta-analysis, prognosis, PD-L1, Bladder cancer, Survival

Received: 11 May 2019; Accepted: 29 Jul 2019.

Copyright: © 2019 Zhu, Sun, Wang, Li, Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Zhibin Li, Shanxi Provincial Cancer Hospital, Taiyuan, China,