Programmed Death Ligand-1 expression in stage II colon cancer: experiences from a nationwide populationbased cohort

Ann C. Eriksen*, Flemming B. Sørensen, Jan Lindebjerg, Henrik Hager, René dePont Christensen, Sanne Kjær-Frifeldt, Torben F. Hansen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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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.

Original languageEnglish
Article number142
JournalBMC Cancer
Number of pages9
Publication statusPublished - 12. Feb 2019


  • Colon cancer stage II
  • Prognostic markers
  • Programmed death ligand-1
  • Immunohistochemistry
  • Predictive Value of Tests
  • Colonic Neoplasms/diagnosis
  • Prognosis
  • B7-H1 Antigen/metabolism
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Survival Analysis
  • Aged, 80 and over
  • Adult
  • Population Groups
  • Aged
  • Neoplasm Staging
  • Cohort Studies


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