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Ghanim, B; Klikovits, T; Hoda, MA; Lang, G; Szirtes, I; Setinek, U; Rozsas, A; Renyi-Vamos, F; Laszlo, V; Grusch, M; Filipits, M; Scheed, A; Jakopovic, M; Samarzija, M; Brcic, L; Stancic-Rokotov, D; Kern, I; Rozman, A; Dekan, G; Klepetko, W; Berger, W; Glasz, T; Dome, B; Hegedus, B.
Ki67 index is an independent prognostic factor in epithelioid but not in non-epithelioid malignant pleural mesothelioma: a multicenter study.
Br J Cancer. 2015; 112(5): 783-792.
Doi: 10.1038/bjc.2015.9
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- Co-authors Med Uni Graz
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Brcic Luka
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- Abstract:
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Estimating the prognosis in malignant pleural mesothelioma (MPM) remains challenging. Thus, the prognostic relevance of Ki67 was studied in MPM.
Ki67 index was determined in a test cohort of 187 cases from three centres. The percentage of Ki67-positive tumour cells was correlated with clinical variables and overall survival (OS). The prognostic power of Ki67 index was compared with other prognostic factors and re-evaluated in an independent cohort (n=98).
Patients with Ki67 higher than median (>15%) had significantly (P<0.001) shorter median OS (7.5 months) than those with low Ki67 (19.1 months). After multivariate survival analyses, Ki67 proved to be-beside histology and treatment-an independent prognostic marker in MPM (hazard ratio (HR): 2.1, P<0.001). Interestingly, Ki67 was prognostic exclusively in epithelioid (P<0.001) but not in non-epithelioid subtype. Furthermore, Ki67 index was significantly lower in post-chemotherapy samples when compared with chemo-naive cases. The prognostic power was comparable to other recently published prognostic factors (CRP, fibrinogen, neutrophil-to-leukocyte ratio (NLR) and nuclear grading score) and was recapitulated in the validation cohort (P=0.048).
This multicentre study demonstrates that Ki67 is an independent and reproducible prognostic factor in epithelioid but not in non-epithelioid MPM and suggests that induction chemotherapy decreases the proliferative capacity of MPM.
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Adult -
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Aged -
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Aged, 80 and over -
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Epithelioid Cells - metabolism Epithelioid Cells - pathology
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Female -
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Humans -
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Ki-67 Antigen - metabolism
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Lung Neoplasms - drug therapy Lung Neoplasms - metabolism Lung Neoplasms - mortality Lung Neoplasms - pathology
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Male -
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Mesothelioma - drug therapy Mesothelioma - metabolism Mesothelioma - mortality Mesothelioma - pathology
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Middle Aged -
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Pleural Neoplasms - drug therapy Pleural Neoplasms - metabolism Pleural Neoplasms - mortality Pleural Neoplasms - pathology
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Survival Analysis -
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Treatment Outcome -
- Find related publications in this database (Keywords)
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malignant pleural mesothelioma
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Ki67 index
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epithelioid histology
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prognostic factor
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multimodality treatment