Does PD-L1 Combined Positive Score Have Prognostic Value in Hypopharyngeal Squamous Cell Carcinoma? A Retrospective...

The aim of this study was to determine whether pretreatment PD-L1 CPS is prognostically associated with survival in patients with HPSCC treated nonsurgically and without immunotherapy, and to assess overall survival (OS) in actively treated patients without distant metastases according to CPS < 1 versus CPS ≥ 1.

This retrospective single-center study included 71 patients; the primary cohort comprised 56 M0 patients receiving active treatment. CPS was categorized as < 1 versus ≥ 1. Overall survival (OS) and progression-free survival (PFS), defined as progression or death, were analyzed using Kaplan-Meier and adjusted Cox models for age, ECOG performance status, grouped T stage, and nodal status. Sensitivity analyses examined broader cohorts and treatment covariates.

In the primary cohort, 47 deaths and 49 PFS events occurred. Median OS was 9 versus 18 months for CPS < 1 versus ≥ 1 (p = 0.001). For CPS ≥ 1 versus < 1, the adjusted hazard ratio (HR) was 0.243 (95% CI, 0.100-0.591; p = 0.002). Median PFS was 5 versus 12 months (p = 0.004), with an adjusted HR of 0.356 (95% CI, 0.149-0.847; p = 0.020). Sensitivity analyses showed consistent OS estimates (adjusted HRs, 0.292-0.455), whereas PFS estimates were attenuated (adjusted HRs, 0.431-0.603; p = 0.051-0.212). Continuous CPS and CPS ≥ 20 were not associated with either outcome; three-category analyses suggested that poorer outcomes in CPS < 1 drove the association.

CPS ≥ 1 was associated with longer OS and PFS in the primary cohort, with consistent OS estimates across sensitivity analyses. These hypothesis-generating findings require external validation and do not support CPS as a standalone treatment-selection marker.

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