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

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 & 2 others Karim Bensalah, Markus Margreiter

Research output: Contribution to journalArticle

11 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1165-1171
Number of pages7
JournalWorld Journal of Urology
Volume33
Issue number8
DOIs
Publication statusPublished - Aug 27 2015

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Prostatectomy
Recurrence
Lymph Nodes
Prostatic Neoplasms
Seminal Vesicles
Proportional Hazards Models
Biomarkers
Staining and Labeling
Survival

Keywords

  • Disease recurrence
  • Ki-67
  • Prognosis
  • Prostate cancer
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Mathieu, R., Shariat, S. F., Seitz, C., Karakiewicz, P. I., Fajkovic, H., Sun, M., ... Margreiter, M. (2015). Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy. World Journal of Urology, 33(8), 1165-1171. https://doi.org/10.1007/s00345-014-1421-3

Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy. / Mathieu, Romain; Shariat, Shahrokh F.; Seitz, Christian; Karakiewicz, Pierre I.; Fajkovic, Harun; Sun, Maxine; Lotan, Yair; Scherr, Douglas S.; Tewari, Ashutosh; Montorsi, Francesco; Briganti, Alberto; Rouprêt, Morgan; Lucca, Ilaria; Margulis, Vitaly; Rink, Michael; Kluth, Luis A.; Rieken, Malte; Bachman, Alexander; Xylinas, Evanguelos; Robinson, Brian D.; Bensalah, Karim; Margreiter, Markus.

In: World Journal of Urology, Vol. 33, No. 8, 27.08.2015, p. 1165-1171.

Research output: Contribution to journalArticle

Mathieu, R, Shariat, SF, Seitz, C, Karakiewicz, PI, Fajkovic, H, Sun, M, Lotan, Y, Scherr, DS, Tewari, A, Montorsi, F, Briganti, A, Rouprêt, M, Lucca, I, Margulis, V, Rink, M, Kluth, LA, Rieken, M, Bachman, A, Xylinas, E, Robinson, BD, Bensalah, K & Margreiter, M 2015, 'Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy', World Journal of Urology, vol. 33, no. 8, pp. 1165-1171. https://doi.org/10.1007/s00345-014-1421-3
Mathieu, Romain ; Shariat, Shahrokh F. ; Seitz, Christian ; Karakiewicz, Pierre I. ; Fajkovic, Harun ; Sun, Maxine ; Lotan, Yair ; Scherr, Douglas S. ; Tewari, Ashutosh ; Montorsi, Francesco ; Briganti, Alberto ; Rouprêt, Morgan ; Lucca, Ilaria ; Margulis, Vitaly ; Rink, Michael ; Kluth, Luis A. ; Rieken, Malte ; Bachman, Alexander ; Xylinas, Evanguelos ; Robinson, Brian D. ; Bensalah, Karim ; Margreiter, Markus. / Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy. In: World Journal of Urology. 2015 ; Vol. 33, No. 8. pp. 1165-1171.
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T1 - Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy

AU - Mathieu, Romain

AU - Shariat, Shahrokh F.

AU - Seitz, Christian

AU - Karakiewicz, Pierre I.

AU - Fajkovic, Harun

AU - Sun, Maxine

AU - Lotan, Yair

AU - Scherr, Douglas S.

AU - Tewari, Ashutosh

AU - Montorsi, Francesco

AU - Briganti, Alberto

AU - Rouprêt, Morgan

AU - Lucca, Ilaria

AU - Margulis, Vitaly

AU - Rink, Michael

AU - Kluth, Luis A.

AU - Rieken, Malte

AU - Bachman, Alexander

AU - Xylinas, Evanguelos

AU - Robinson, Brian D.

AU - Bensalah, Karim

AU - Margreiter, Markus

PY - 2015/8/27

Y1 - 2015/8/27

N2 - 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.

AB - 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.

KW - Disease recurrence

KW - Ki-67

KW - Prognosis

KW - Prostate cancer

KW - Radical prostatectomy

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