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

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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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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study has been approved by the appropriate ethics committee.

Author information

Authors and Affiliations

  1. Department of Urology, Rennes University Hospital, Rennes, France

    Romain Mathieu & Karim Bensalah

  2. Department of Urology, General Hospital, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Shahrokh F. Shariat, Christian Seitz, Harun Fajkovic, Ilaria Lucca & Markus Margreiter

  3. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada

    Pierre I. Karakiewicz & Maxine Sun

  4. Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

    Shahrokh F. Shariat, Yair Lotan & Vitaly Margulis

  5. Department of Urology, Weill Cornell Medical College, New York, NY, USA

    Shahrokh F. Shariat, Douglas S. Scherr, Ashutosh Tewari & Brian D. Robinson

  6. Department of Urology, Vita-Salute San Raffaele University, Milan, Italy

    Francesco Montorsi & Alberto Briganti

  7. Academic Department of Urology, Faculté de Médecine Pierre et Marie Curie, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, University Paris 6, Paris, France

    Morgan Rouprêt

  8. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Michael Rink & Luis A. Kluth

  9. Department of Urology, University Hospital Basel, Basel, Switzerland

    Malte Rieken & Alexander Bachman

  10. Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France

    Evanguelos Xylinas

  11. Department of Pathology, Weill Cornell Medical College, New York, NY, USA

    Brian D. Robinson

  12. Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

    Ilaria Lucca

Authors
  1. Romain Mathieu
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  2. Shahrokh F. Shariat
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  3. Christian Seitz
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  4. Pierre I. Karakiewicz
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  5. Harun Fajkovic
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  6. Maxine Sun
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  7. Yair Lotan
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  8. Douglas S. Scherr
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  9. Ashutosh Tewari
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  10. Francesco Montorsi
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  11. Alberto Briganti
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  12. Morgan Rouprêt
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  13. Ilaria Lucca
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  14. Vitaly Margulis
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  15. Michael Rink
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  16. Luis A. Kluth
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  17. Malte Rieken
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  18. Alexander Bachman
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  19. Evanguelos Xylinas
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  20. Brian D. Robinson
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  21. Karim Bensalah
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  22. Markus Margreiter
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Corresponding author

Correspondence to Markus Margreiter.

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Mathieu, R., Shariat, S.F., Seitz, C. et al. Multi-institutional validation of the prognostic value of Ki-67 labeling index in patients treated with radical prostatectomy. World J Urol 33, 1165–1171 (2015). https://doi.org/10.1007/s00345-014-1421-3

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  • DOI: https://doi.org/10.1007/s00345-014-1421-3

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