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01-08-2015 | Original Article

Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy

Authors: Romain Mathieu, Shahrokh F. Shariat, Christian Seitz, Pierre I. Karakiewicz, Harun Fajkovic, Maxine Sun, Yair Lotan, Douglas S. Scherr, Ashutosh Tewari, Francesco Montorsi, Alberto Briganti, Morgan Rouprêt, Ilaria Lucca, Vitaly Margulis, Michael Rink, Luis A. Kluth, Malte Rieken, Alexander Bachman, Evanguelos Xylinas, Brian D. Robinson, Karim Bensalah, Markus Margreiter

Published in: World Journal of Urology | Issue 8/2015

Abstract

Objective

Several smaller single-center studies have reported a prognostic role for Ki-67 labeling index in prostate cancer. Our aim was to test whether Ki-67 is an independent prognostic marker of biochemical recurrence (BCR) in a large international cohort of patients treated with radical prostatectomy (RP).

Methods

Ki-67 immunohistochemical staining on prostatectomy specimens from 3,123 patients who underwent RP for prostate cancer was retrospectively performed. Univariable and multivariable Cox regression models were used to assess the association of Ki-67 status with BCR.

Results

Ki-67 positive status was observed in 762 (24.4 %) patients and was associated with lymph node involvement (LNI) (p = 0.039). Six hundred and twenty-one (19.9 %) patients experienced BCR. The estimated 3-year biochemical-free survivals were 85 % for patients with negative Ki-67 status and 82.1 % for patients with positive Ki-67 status (log-rank test, p = 0.014). In multivariable analysis that adjusted for the effects of age, preoperative PSA, RP Gleason sum, seminal vesicle invasion, extracapsular extension, positive surgical margins, lymphovascular invasion, and LNI, Ki-67 was significantly associated with BCR (HR = 1.19; p = 0.019). Subgroup analysis revealed that Ki-67 is associated with BCR in patients without LNI (p = 0.004), those with RP Gleason sum 7 (p = 0.015), and those with negative surgical margins (p = 0.047).

Conclusion

We confirmed Ki-67 as an independent predictor of BCR after RP. Ki-67 could be particularly informative in patients with favorable pathologic characteristics to help in the clinical decision-making regarding adjuvant therapy and optimized follow-up scheduling.

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Title: Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy
Authors: Romain Mathieu
Shahrokh F. Shariat
Christian Seitz
Pierre I. Karakiewicz
Harun Fajkovic
Maxine Sun
Yair Lotan
Douglas S. Scherr
Ashutosh Tewari
Francesco Montorsi
Alberto Briganti
Morgan Rouprêt
Ilaria Lucca
Vitaly Margulis
Michael Rink
Luis A. Kluth
Malte Rieken
Alexander Bachman
Evanguelos Xylinas
Brian D. Robinson
Karim Bensalah
Markus Margreiter
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 8/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1421-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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