Abstract
BackgroundKi-67 is known to be useful in estimating the fraction of proliferation tumor cells in various malignancies. We tried to investigate clinical association of Ki-67 (MIB-1) expression with the oncological outcomes in patients with localized prostate cancer (PCa) after the radical prostatectomy (RP).Materials and MethodsWe retrospectively analyzed the data of 1,561 patients who underwent RP for localized PCa. According to the propensity score having Ki-67 expression, 183 patients with positive Ki-67 expression were matched to 549 patients without Ki-67 expression. By using multivariate Cox-proportional hazards models and logistic regression tests, the prognostic value of each variable was tested.ResultsAfter propensity score matching, positive Ki-67 group showed significant worse clinical characteristics and pathologic outcomes than negative Ki-67 group. The multivariate analysis showed that the Ki-67 expression was significantly associated with several adverse pathologic outcomes including higher pathologic stage (p = 0.006), higher grade group (p = 0.005), seminal vesicle invasion (p = 0.036), and positive surgical margin (p = 0.025). The group with Ki-67 expression showed significant worse biochemical recurrence-free survival (p<0.001) than negative Ki-67 group. Subsequent multivariate Cox analyses showed that Ki-67 was independent predictor for BCR after RP (HR 1.549, 95% CI 1.187–2.021, p = 0.001).ConclusionIn our study, high Ki-67 expression was significantly related with adverse pathological and finally with worse biochemical recurrence-free survival. Further studies are needed to validate the prognostic value of Ki-67 more exactly in PCa patients.
Highlights
Prostate cancer is the most frequently diagnosed malignancy in United States, and the fifth common malignancy in the world [1]
The multivariate analysis showed that the Ki-67 expression was significantly associated with several adverse pathologic outcomes including higher pathologic stage (p = 0.006), higher grade group (p = 0.005), seminal vesicle invasion (p = 0.036), and positive surgical margin (p = 0.025)
Subsequent multivariate Cox analyses showed that Ki-67 was independent predictor for biochemical recurrence (BCR) after radical prostatectomy (RP) (HR 1.549, 95% CI 1.187–2.021, p = 0.001)
Summary
Prostate cancer is the most frequently diagnosed malignancy in United States, and the fifth common malignancy in the world [1]. The Ki-67 protein is well known and widely utilized as a proliferation marker of tumor cells [4]. The function of Ki-67 antigen is still not unknown, but Ki-67 antigens are exclusively present only in proliferating cells. The proportion of Ki-67 protein in tumor cells expected to have a prognostic value in several different types of malignancy. We aimed to evaluate the prognostic impact of Ki-67 expression after radical prostatectomy in patients with clinically localized prostate cancer using the propensity score matching method. Ki-67 is known to be useful in estimating the fraction of proliferation tumor cells in various malignancies. We tried to investigate clinical association of Ki-67 (MIB-1) expression with the oncological outcomes in patients with localized prostate cancer (PCa) after the radical prostatectomy (RP).
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