AUTHOR=Lu Yi , Wang Yutao , Su Hao , Li Hongjun 

TITLE=PD-L1 is associated with the prognosis of penile cancer: A systematic review and meta-analysis

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1013806

DOI=10.3389/fonc.2022.1013806

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Previous studies have explored the role of PD-L1 in the survival outcomes of penile cancer patients with controversies existed. Thus, the meta-analysis was conducted to report and review the association between PD-L1 and survival in penile cancer patients.</p></sec><sec><title>Methods</title><p>PubMed, Cochrane Library, EMBASE, and Web of Science were all searched, screened, and reviewed by June 1, 2022. Hazard ratio (HR) was used to evaluate the relationship between PD-L1 and survival outcome, and odds ratio (OR) was for tumor features.</p></sec><sec><title>Results</title><p>Nine retrospective studies (1,003 patients) were incorporated. The prevalence of PD-L1 in patients with penile cancer was 51.4% (95% CI = 42.1%-60.8%, <italic>I</italic><sup>2</sup> = 88.5%). Higher PD-L1 on tumor cells was related to shorter cancer-specific survival (CSS) in patients (HR = 1.578, 95% CI = 1.227-2.029, <italic>I</italic><sup>2</sup> = 23.3%), but had no associations with overall survival (OS) (HR = 1.123, 95% CI = 0.511-2.465, <italic>I</italic><sup>2</sup> = 0.0%). Subgroup analysis indicated that higher PD-L1 was related to shorter CSS in Caucasus (HR = 1.827, 95% CI = 1.355-2.465, <italic>I</italic><sup>2</sup> = 0.0%) only. Furthermore, PD-L1 had associations with tumor stage (pT1 vs. pT2-4, OR = 0.480, 95% CI = 0.346-0.667, <italic>P</italic> = 0.001) and tumor grade (Well and moderate vs. Poor, OR = 0.377, 95% CI = 0.264-0.538, <italic>P</italic> &lt; 0.001). PD-L1 positivity was also related to lymph node (LN) status (pN0/NX vs. pN1–3, OR = 0.541, 95% CI = 0.385-0.759, <italic>P</italic> = 0.001) and HPV status (Positive vs. Negative, OR = 0.510, 95% CI = 0.322-0.810, <italic>P</italic> = 0.003). A trend toward statistical significance between PD-L1 and histological types was also observed (Usual SCC vs. Others, OR = 1.754, 95% CI = 0.984-3.124, <italic>P</italic> = 0.070).</p></sec><sec><title>Conclusions</title><p>PD-L1 over-expression was related to worse survival outcomes and several clinicopathological features of penile cancer. PD-L1 expression can be applied to select appropriate treatment strategies for penile malignancies.</p></sec><sec><title>Systematic review registration</title><p><uri xlink:href="https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=343041" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=343041</uri>, identifier CRD42022343041.</p></sec>