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The main focus has been on tumor cell PD-L1 expression, but its assessment alone is insufficient for patient selection in most malignancies. We mapped the presence of macrophages (CD68 and CD163) and lymphocytes (CD3) located within the tumor epithelium, the cell type\u2013specific expression of PD-L1 and PD-1, and their impact on 5-year overall survival (OS) in a consecutive cohort of 130 women diagnosed with advanced HGSC between 2011 and 2015. PD-L1 was expressed mainly by macrophages (not by tumor cells) and PD-1 by lymphocytes. Women with higher CD3, PD-L1, and PD-1 expression had improved OS (<jats:italic>P<\/jats:italic>\u2009=\u20090.03,<jats:italic>P<\/jats:italic>\u2009=\u20090.007, and<jats:italic>P<\/jats:italic>\u2009=\u20090.02, respectively). In the external data set (203 women), high expression of<jats:italic>CD274<\/jats:italic>(encoding PD-L1) was associated with improved OS (<jats:italic>P<\/jats:italic>\u2009=\u20090.03), in accordance with our results. Furthermore, higher CD163 expression was associated with better outcome in women with no residual tumor after primary surgery (<jats:italic>P<\/jats:italic>\u2009=\u20090.02). Thus, women with greater lymphocyte tumor infiltration had better outcome and PD-L1\/PD-1 expression, regardless of PD-1\/PD-L1 being markers for immune suppressive pathways, conferred a survival benefit in our cohort. Our results highlight that tumor immunity may be harnessed in subsets of HGSC.<\/jats:p>","DOI":"10.1007\/s00428-020-02751-6","type":"journal-article","created":{"date-parts":[[2020,1,25]],"date-time":"2020-01-25T02:02:41Z","timestamp":1579917761000},"page":"83-91","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["PD-1\/PD-L1 expression and tumor-infiltrating lymphocytes are prognostically favorable in advanced high-grade serous ovarian carcinoma"],"prefix":"10.1007","volume":"477","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3618-8282","authenticated-orcid":false,"given":"Laura","family":"Martin de la Fuente","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Westbom-Fremer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolai Skovbjerg","family":"Arildsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Hartman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Malander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"Kannisto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"M\u00e5sb\u00e4ck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Hedenfalk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,24]]},"reference":[{"issue":"6","key":"2751_CR1","doi-asserted-by":"publisher","first-page":"1234","DOI":"10.1002\/cncr.24149","volume":"115","author":"A du Bois","year":"2009","unstructured":"du Bois A, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J (2009) Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d\u2019Investigateurs Nationaux pour les etudes des cancers de l\u2019Ovaire (GINECO). 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Dr. Martin de la Fuente received grant support from Roche in collaboration with the Swedish Society of Gynecological Oncology. The rest of the authors declare that they have no conflicts of interest to report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}