---
title: "PD-L1 Expression and Clinical Outcomes in Oral Squamous Cell Carcinoma: Large Cohort Analysis"
id: "pubmed-42665707"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42665707"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42665707/"
doi: "10.1007/s10006-026-01628-3"
published_at: "2026-08-29T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# PD-L1 Expression and Clinical Outcomes in Oral Squamous Cell Carcinoma: Large Cohort Analysis
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42665707
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42665707/)
- **DOI:** [10.1007/s10006-026-01628-3](https://doi.org/10.1007%2Fs10006-026-01628-3)
- **Published At:** 2026-08-29T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This single-center cohort study assessed **PD-L1** expression by the Combined Positive Score (CPS) in 156 consecutive surgically treated oral squamous cell carcinoma (**OSCC**) patients to determine its prognostic significance. - PD-L1 positivity was prespecified as **CPS ≥ 10**; sensitivity analyses used CPS ≥ 1 and CPS ≥ 20. - Overall, 120 of 156 patients (76.9%) were PD-L1–positive at the CPS ≥ 10 cutoff. - PD-L1 status showed no association with examined clinicopathological variables in this cohort. - At 3 years, survival and recurrence estimates were similar between PD-L1–positive and PD-L1–negative groups: OS 76.1% vs 68.7%; DFS 63.5% vs 42.6%; LRCR 77.1% vs 75.5%; NCR 93.0% vs 91.0%. - Multivariable Cox models found no association between PD-L1 (binary or continuous CPS) and OS, DFS, LRCR, or NCR at CPS ≥ 10; results were consistent at CPS ≥ 20. - In subgroup analysis stratified by adjuvant therapy, PD-L1 positivity correlated with improved DFS only among patients who did not receive adjuvant therapy; no benefit was seen in those who did. - At the lowest threshold (CPS ≥ 1), PD-L1 positivity was associated with superior OS (HR 0.280; 95% CI 0.106–0.745; p = 0.011), but authors note this finding is driven by a very small PD-L1–negative reference group and caution against overinterpretation. - Mean follow-up was 15.7 ± 12.5 months; the limited observation time precludes conclusions about late recurrence or long-term survival. - Authors declared no conflicts of interest; data argue against a reliable standalone prognostic value of **PD-L1** by CPS in the early postoperative period for surgically treated OSCC.
## Clinical Analysis & Structured Key Points
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Michael-georg.alfertshofer@charite.de.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#full-view-affiliation-2 "Department of Plastic and Hand Surgery, Technical University Munich, Munich, Germany. Michael-georg.alfertshofer@charite.de."), [Maximilian Richter](https://pubmed.ncbi.nlm.nih.gov/?term=Richter+M&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#full-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Konrad Klinghammer](https://pubmed.ncbi.nlm.nih.gov/?term=Klinghammer+K&cauthor_id=42665707)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#full-view-affiliation-4 "Division of Hematology, Oncology and Tumorimmunololgy, Charité - Universitätsmedizin Berlin, Comprehensive Cancer Center, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Christian Doll](https://pubmed.ncbi.nlm.nih.gov/?term=Doll+C&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#full-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Steffen Koerdt](https://pubmed.ncbi.nlm.nih.gov/?term=Koerdt+S&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#full-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Max Heiland](https://pubmed.ncbi.nlm.nih.gov/?term=Heiland+M&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#full-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Friedrich Mrosk](https://pubmed.ncbi.nlm.nih.gov/?term=Mrosk+F&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#full-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany.") Affiliations Expand ### Affiliations * 1 Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany. Michael-georg.alfertshofer@charite.de. * 2 Department of Plastic and Hand Surgery, Technical University Munich, Munich, Germany. Michael-georg.alfertshofer@charite.de. * 3 Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany. * 4 Division of Hematology, Oncology and Tumorimmunololgy, Charité - Universitätsmedizin Berlin, Comprehensive Cancer Center, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany. * PMID: **42665707** * DOI: [ 10.1007/s10006-026-01628-3 ](https://doi.org/10.1007/s10006-026-01628-3) Item in Clipboard # Programmed Death-Ligand 1 (PD-L1) expression and clinical outcomes in oral squamous cell carcinoma: evidence from a large clinical cohort Michael Alfertshofer et al. Oral Maxillofac Surg. 2026. Show details Display options Display options Format Abstract PubMed PMID Oral Maxillofac Surg Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Oral+Maxillofac+Surg%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Oral+Maxillofac+Surg%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665707/) . 2026 Aug 29;30(1):144. doi: 10.1007/s10006-026-01628-3. ### Authors [Michael Alfertshofer](https://pubmed.ncbi.nlm.nih.gov/?term=Alfertshofer+M&cauthor_id=42665707)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#short-view-affiliation-1 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany. Michael-georg.alfertshofer@charite.de.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#short-view-affiliation-2 "Department of Plastic and Hand Surgery, Technical University Munich, Munich, Germany. Michael-georg.alfertshofer@charite.de."), [Maximilian Richter](https://pubmed.ncbi.nlm.nih.gov/?term=Richter+M&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#short-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Konrad Klinghammer](https://pubmed.ncbi.nlm.nih.gov/?term=Klinghammer+K&cauthor_id=42665707)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#short-view-affiliation-4 "Division of Hematology, Oncology and Tumorimmunololgy, Charité - Universitätsmedizin Berlin, Comprehensive Cancer Center, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Christian Doll](https://pubmed.ncbi.nlm.nih.gov/?term=Doll+C&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#short-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Steffen Koerdt](https://pubmed.ncbi.nlm.nih.gov/?term=Koerdt+S&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#short-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Max Heiland](https://pubmed.ncbi.nlm.nih.gov/?term=Heiland+M&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#short-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany."), [Friedrich Mrosk](https://pubmed.ncbi.nlm.nih.gov/?term=Mrosk+F&cauthor_id=42665707)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665707/#short-view-affiliation-3 "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany.") ### Affiliations * 1 Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany. Michael-georg.alfertshofer@charite.de. * 2 Department of Plastic and Hand Surgery, Technical University Munich, Munich, Germany. Michael-georg.alfertshofer@charite.de. * 3 Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany. * 4 Division of Hematology, Oncology and Tumorimmunololgy, Charité - Universitätsmedizin Berlin, Comprehensive Cancer Center, corporate member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin, Germany. * PMID: **42665707** * DOI: [ 10.1007/s10006-026-01628-3 ](https://doi.org/10.1007/s10006-026-01628-3) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Despite the recognized biological relevance of the PD-1/PD-L1 axis in immune evasion, the prognostic significance of PD-L1 expression in surgically treated oral squamous cell cancer (OSCC) patients remains largely unclear. **Objective:** To investigate the prognostic significance of PD-L1 expression in a large cohort of OSCC patients primarily treated surgically in a single center. **Methods:** This analysis included 156 consecutive OSCC patients treated with curative-intent surgery with their clinicopathologic variables, treatment details and clinical treatment outcomes. PD-L1 expression was categorized using the Combined Positive Score (CPS), defining PD-L1 positivity as CPS ≥ 10. Sensitivity analyses were repeated at the alternative thresholds CPS ≥ 1 and CPS ≥ 20. Survival and recurrence endpoints (OS, DFS, LRCR, NCR) were evaluated using Kaplan-Meier/log-rank methods and Cox regression with multivariable adjustment for key confounders. **Results:** Of 156 consecutive OSCC patients, 120 (76.9%) were PD-L1-positive. PD-L1 status was not associated with any clinicopathological parameter investigated herein. At 3 years, OS (76.1% vs. 68.7%), DFS (63.5% vs. 42.6%), LRCR (77.1% vs. 75.5%), and NCR (93.0% vs. 91.0%) were comparable between PD-L1-positive and PD-L1-negative patients, respectively. Neither binary PD-L1 classification nor continuous CPS was associated with OS, DFS, LRCR, or NCR in multivariable Cox regression, with no differential effect by disease stage. In adjuvant-treatment-stratified analysis, PD-L1 positivity was associated with improved DFS in patients without adjuvant therapy, but not in those who received it. In sensitivity analyses, findings at CPS ≥ 20 were concordant with the primary analysis, whereas at CPS ≥ 1 PD-L1 positivity was associated with superior OS (HR = 0.280 [95% CI: 0.106-0.745]; p = 0.011). **Conclusion:** Within a mean follow-up of 15.7 ± 12.5 months, PD-L1 expression assessed by CPS was not independently associated with survival or recurrence outcomes in surgically treated OSCC at the prespecified cutoff of CPS ≥ 10, nor at CPS ≥ 20. An isolated overall survival association at CPS ≥ 1 was driven by a very small PD-L1-negative reference group and should not be regarded as robust. Taken together, these data argue against a reliable standalone prognostic value of PD-L1 in the early postoperative period while the limited observation time does not permit conclusions on late recurrence or long-term survival. **Keywords:** Head and neck squamous cell carcinoma; Overall survival; PD-L1 expression; Prognostic biomarkers. © 2026. The Author(s). [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Author disclosure: The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article. Competing interests: The authors declare no competing interests. ## Similar articles * [ High PD-L1 expression as a negative prognostic factor in stage III but not in stage II gastric cancer. ](https://pubmed.ncbi.nlm.nih.gov/41809879/) Zhang HM, Li FP, Zhang HY, Liu XR, Chen XH, Liang HY, Yan X, Xie Q, Zhong R, Lai M, Zhong XF, Liu H, Zhao LY.Zhang HM, et al.World J Gastroenterol. 2026 Feb 28;32(8):115333. doi: 10.3748/wjg.v32.i8.115333.World J Gastroenterol. 2026.PMID: 41809879Free PMC article. * [ Does high PD-L1 expression reduce the risk of relapse after definitive surgery in patients with oral cavity cancer? ](https://pubmed.ncbi.nlm.nih.gov/40266268/) Babayev P, Ismayilov R, Kuscu O, Akyildiz A, Kurtulan O, Pamuk E, Guler Tezel YG, Gullu IH.Babayev P, et al.Acta Otolaryngol. 2025 Jul;145(7):648-653. doi: 10.1080/00016489.2025.2489645. Epub 2025 Apr 23.Acta Otolaryngol. 2025.PMID: 40266268 * [ Prognostic significance of PD-L2 expression in patients with oral squamous cell carcinoma-A comparison to the PD-L1 expression profile. ](https://pubmed.ncbi.nlm.nih.gov/30659749/) Weber M, Wehrhan F, Baran C, Agaimy A, Büttner-Herold M, Kesting M, Ries J.Weber M, et al.Cancer Med. 2019 Mar;8(3):1124-1134. doi: 10.1002/cam4.1929. Epub 2019 Jan 18.Cancer Med. 2019.PMID: 30659749Free PMC article. * [ Relationship of programmed death ligand-1 expression with clinicopathological features and prognosis in patients with oral squamous cell carcinoma: A meta-analysis. ](https://pubmed.ncbi.nlm.nih.gov/32344357/) He J, Chen XF, Xu MG, Zhao J.He J, et al.Arch Oral Biol. 2020 Jun;114:104717. doi: 10.1016/j.archoralbio.2020.104717. Epub 2020 Apr 11.Arch Oral Biol. 2020.PMID: 32344357Review. * [ The prognostic role of PD-L1 expression for survival in head and neck squamous cell carcinoma: A systematic review and meta-analysis. ](https://pubmed.ncbi.nlm.nih.gov/30409325/) Yang WF, Wong MCM, Thomson PJ, Li KY, Su YX.Yang WF, et al.Oral Oncol. 2018 Nov;86:81-90. doi: 10.1016/j.oraloncology.2018.09.016. Epub 2018 Sep 17.Oral Oncol. 2018.PMID: 30409325 [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42665707) ## References 1. 1. Vesely MD, Kershaw MH, Schreiber RD, Smyth MJ (2011) Natural innate and adaptive immunity to cancer. Annu Rev Immunol 29:235–271. - [DOI](https://doi.org/10.1146/annurev-immunol-031210-101324) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/21219185/) 2. 1. Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144(5):646–674. - [DOI](https://doi.org/10.1016/j.cell.2011.02.013) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/21376230/) 3. 1.
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