Tumor B7-H1 is associated with poor prognosis in renal cell carcinoma patients with long-term follow-up

R. Houston Thompson, Susan M. Kuntz, Bradley C. Leibovich, Haidong Dong, Christine M. Lohse, W. Scott Webster, Shomik Sengupta, Igor Frank, Alexander S. Parker, Horst Zincke, Michael L. Blute, Thomas J. Sebo, John C. Cheville, Eugene D. Kwon

Research output: Contribution to journalArticlepeer-review

673 Scopus citations


B7-H1 participates in T-cell costimulation functioning as a negative regulator of immunity. Recent observations suggest that B7-H1 is expressed by renal cell carcinoma (RCC) tumor cells and is associated with poor prognosis. However, outcome analyses have been restricted to patients with fresh-frozen tissue and limited follow-up. We report the clinical effect of B7-H1 in RCC patients with a median of 10 years of follow-up. Between 1990 and 1994, 306 patients underwent nephrectomy for clear cell RCC and had paraffin tissue available for review. We did immunohistochemistry with anti-B7-H1 and conducted outcome analyses. Among the 306 patients, 73 (23.9%) harbored tumors with B7-H1 expression. Patients with tumor B7-H1 were at a significantly increased risk of both death from RCC [risk ratio (RR), 3.92; P < 0.001] and overall mortality (RR, 2.37; P < 0.001). The 5-year cancer-specific survival rates were 41.9% and 82.9% for patients with and without tumor B7-H1, respectively. In a multivariate model, tumor B7-H1 remained associated with cancer-specific death even after adjusting for tumor-node-metastasis stage, grade, and performance status (RR, 2.00; P = 0.003). In the subset of 268 patients with localized RCC, tumor B7-H1 was significantly associated with metastatic cancer progression (RR, 3.46; P < 0.001) and death from RCC (RR, 4.13; P < 0.001) even after adjusting for stage, grade, and performance status (RR, 1.78, P = 0.036). RCC patients with tumor B7-H1 are at significant risk of rapid cancer progression and accelerated rates of mortality. B7-H1 may function as a key determinant in RCC, abrogating immune responses directed against this immunogenic tumor.

Original languageEnglish (US)
Pages (from-to)3381-3385
Number of pages5
JournalCancer research
Issue number7
StatePublished - Apr 1 2006

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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