45 Prognostic value of MIB-1, PD-L1 and nuclear size in SST after CRT The limitations of the study are the relatively small number of patients and the lack of sufficient preoperative biopsy tumour tissue to compare MIB-1 and PD-L1 levels before and after therapy. The relatively low numbers of cases did not allow multivariate statistical analysis between the different prognostic items such as percentage vital tumour cells, N- and R -status, stage and the immunohistochemical and morphometric results. In summary, this study shows an increase in nuclear size of tumour cells after chemoradiotherapy, which has no prognostic significance in patients treated with trimodality for SST. Importantly, low MIB-1 expression was associated with improved OS and DFS, and negative PD-L1 expression predicts better OS. Further study may be useful to investigate whether patients with residual tumour after trimodality therapy and high PDL-1 status may benefit from adjuvant immunotherapy. 3
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