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Prognostic value of Ki-67 expression in conversion therapy for colorectal liver-limited metastases.


ABSTRACT: INTRODUCTION:The objective of this study was to examine the prognostic value of Ki-67 expression in conversion therapy for colorectal liver-confined metastases. METHODS:We enrolled a total of 96 patients including 54 patients who received oxaliplatin- or irinotecan-based chemotherapy and curative hepatectomy for initially unresectable metastases (conversion group) and 42 patients with initially resectable liver metastases (straight hepatectomy group). Ki-67 expression was examined in 96 resected specimens but excluded the 2 specimens that revealed no residual cancer cells in conversion group. RESULTS:Conversion therapy leads to greater survival that is equivalent to that straight hepatectomy group. In conversion group, high Ki-67 expression (> 30%) levels were detectable in 33 patients (64%) after chemotherapy prior to conversion therapy. High Ki-67 expression was significantly associated with shorter disease-free survival and worse overall survival (P < 0.01 in both), and was an independent worse prognostic factor of disease-free survival and overall survival (hazard ratio [HR] and P-values were 5.608, 0.001 and 5.366, 0.04, respectively) in patients with conversion therapy. Interestingly, even in the patients with RECIST PR (n = 32), high Ki-67 expression was significantly shorter disease-free survival compared to low Ki-67 expression (P < 0.001). In contrast to conversion group, there was no significant difference in disease free survival and overall survival between low (n = 14, 33%) and high (n = 28, 67%) Ki-67 expressions in patients with straight hepatectomy (P = 0.14 and 0.74, respectively). CONCLUSIONS:Residual Ki-67 expression is a useful biomarker for worse prognostic outcomes after conversion therapy. High Ki-67 expression may be a biomarker of micrometastases containing aggressive cancer cells.

SUBMITTER: Hayashi H 

PROVIDER: S-EPMC4449450 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Prognostic value of Ki-67 expression in conversion therapy for colorectal liver-limited metastases.

Hayashi Hiromitsu H   Beppu Toru T   Sakamoto Yasuo Y   Miyamoto Yuji Y   Yokoyama Naomi N   Higashi Takaaki T   Nitta Hidetoshi H   Hashimoto Daisuke D   Chikamoto Akira A   Baba Hideo H  

American journal of cancer research 20150215 3


<h4>Introduction</h4>The objective of this study was to examine the prognostic value of Ki-67 expression in conversion therapy for colorectal liver-confined metastases.<h4>Methods</h4>We enrolled a total of 96 patients including 54 patients who received oxaliplatin- or irinotecan-based chemotherapy and curative hepatectomy for initially unresectable metastases (conversion group) and 42 patients with initially resectable liver metastases (straight hepatectomy group). Ki-67 expression was examined  ...[more]

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