Ki67 Tumor Expression Predicts Treatment Benefit Achieved by Macroscopic Radical Lung-Preserving Surgery in Pleural Mesothelioma-A Retrospective Multicenter Analysis

Hintermair S., Iser S., Varga A., Biesinger M., Bohanes T., Celik A., ...Daha Fazla

CANCERS, cilt.16, sa.10, 2024 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 16 Sayı: 10
  • Basım Tarihi: 2024
  • Doi Numarası: 10.3390/cancers16101817
  • Dergi Adı: CANCERS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, Veterinary Science Database, Directory of Open Access Journals
  • Anahtar Kelimeler: cytoreductive surgery, inflammation, Ki67 index, lung-sparing surgery, macroscopic complete resection, multimodality treatment, pleural mesothelioma, predictive biomarker, prognostic biomarker
  • Gazi Üniversitesi Adresli: Evet

Özet

Pleural mesothelioma (PM) is characterized by its poor prognosis due to late-stage diagnosis, limited effective treatment options and the lack of biomarkers for treatment decision. The role of macroscopic radical surgery has therefore been questioned. Thus, there is an urgent need for predictive biomarkers aiding clinicians in tailoring more personalized and effective therapeutic strategies. Besides validating the prognostic role of Ki67 expression in tumor samples in 70 PM patients from two different centers with detailed clinical characteristics, here we suggest for the first time Ki67 as a biomarker to predict the patient's benefit from lung-sparing surgery within multimodality therapy in epithelioid mesothelioma. Pleural mesothelioma (PM), linked to asbestos-induced inflammation, carries a poor prognosis. Therapy ranges from therapy limitation to aggressive multimodality treatment. Given the uncertainty about treatment benefits for patients, this study aimed to assess the role of Ki67 as a prognostic and predictive parameter in PM. Ki67 was measured in the specimens of 70 PM patients (17 female, 53 male) from two centers and correlated to overall survival (OS) and therapy outcome. The median OS was 16.1 months. The level of Ki67 expression was divided into low (<= 15%) and high (>15%). A low value of Ki67 expression was associated with a longer OS (Ki67 <= 15%: 31.2 (95% CI 6.5-55.8) months vs. Ki67 > 15%: 11.1 (95% CI 7.7-14.6) months, p = 0.012). The 5-year survival represents 22% in the low Ki67 expression group, in contrast to 5% in the high Ki67 expression group. We found a significant interaction term of Ki67 with multimodality treatment (p = 0.031) translating to an OS of 48.1 months in the low expression Ki67 group compared to 24.3 months in the high Ki67 expression group when receiving surgery within multimodality therapy. Therefore, Ki67 stands out as a validated prognostic and, most importantly, novel predictive biomarker for treatment benefits, particularly regarding surgery within multimodality therapy.