Transatlantic Prostate G. Prognostic value of Ki-67 for prostate cancer death in a conservatively managed cohort

Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.
British Journal of Cancer (Impact Factor: 4.84). 01/2013; 108(2). DOI: 10.1038/bjc.2012.598
Source: PubMed


Standard clinical parameters cannot accurately differentiate indolent from aggressive prostate cancer. Our previous work showed that immunohistochemical (IHC) Ki-67 improved prediction of prostate cancer death in a cohort of conservatively treated clinically localised prostate cancers diagnosed by transurethral resection of the prostate (TURP). Here, we present results in a more clinically relevant needle biopsy cohort.

Biopsy specimens were microarrayed. The percentage of Ki-67 positively stained malignant cells per core was measured and the maximum score per individual used in analysis of time to death from prostate cancer using a Cox proportional hazards model.

In univariate analysis (n=293), the hazard ratio (HR) (95% confidence intervals) for dichotomous Ki-67 (⩽10%, >10%) was 3.42 (1.76, 6.62) χ2 (1 df)=9.8, P=0.002. In multivariate analysis, Ki-67 added significant predictive information to that provided by Gleason score and prostate-specific antigen (HR=2.78 (1.42, 5.46), χ2 (1 df)=7.0, P=0.008).

The IHC Ki-67 scoring on prostate needle biopsies is practicable and yielded significant prognostic information. It was less informative than in the previous TURP cohort where tumour samples were larger and more comprehensive, but in more contemporary cohorts with larger numbers of biopsies per patient, Ki-67 may prove a more powerful biomarker.

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Available from: Sakunthala C Kudahetti, Feb 14, 2014
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    • "Even when simplifying the multivariate model , excluding margins and patient age , the number of significantly prognostic biomarkers did not increase ( data not shown ) . However , a caveat to the validity of the current study is that Ki - 67 , which is assumedly the best verified prognostic marker in prostate cancer , only showed a univariate significance ( Kristiansen , 2012 ; Fisher et al , 2013 ) . "
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    British Journal of Cancer 11/2014; 112(1). DOI:10.1038/bjc.2014.588 · 4.84 Impact Factor
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    • "Tolonen et al. demonstrated that Ki-67 in 247 primarily endocrine-treated prostate cancer patients was associated with progression-free survival [63]. Ki-67 labeling ≥ 10% on 293 microarrayed needle-biopsies had independent predictive value for disease-specific death together with Gleason score and PSA [61]. Recently, Tollefson et al. calculated in a cohort of 451 prostate cancer needle-biopsies that every 1% increase in Ki-67 expression resulted in a 12% increased risk of cancer-specific death after radical prostatectomy [29]. "
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    BioMed Research International 08/2014; 2014:12. DOI:10.1155/2014/341324 · 3.17 Impact Factor
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    • "Mitotic index that regulates the cell-cycle Increased Ki-67 staining index correlates with higher Gleason score. Together with other molecular markers, it helps to determine the risk of PCa progression Tissue Prognosis Steuber et al., 2007; Madani et al., 2011; Josefsson et al., 2012; Fisher et al., 2013 Lactate dehydro-genase (LDH) "
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