High Ki-67 proliferative index predicts disease specific survival in patients with high-risk soft tissue sarcomas Journal Article


Authors: Hoos, A.; Stojadinovic, A.; Mastorides, S.; Urist, M. J.; Polsky, D.; Di Como, C. J.; Brennan, M. F.; Cordon-Cardo, C.
Article Title: High Ki-67 proliferative index predicts disease specific survival in patients with high-risk soft tissue sarcomas
Abstract: BACKGROUND. Soft tissue sarcomas (STSs) are heterogeneous neoplasms that have variable clinical outcome. Several clinical parameters and few molecular markers, including Ki-67 proliferative index, have been shown to correlate with patient prognosis. To the authors' knowledge, no definitive report exists to identify one molecular marker that can be analyzed easily in a clinical setting and that predicts survival in a cohort of patients with high-risk STS of identical clinical characteristics but variable outcome. METHODS. The influence of clinical prognostic factors was eliminated by selecting two patient groups with identical high-risk characteristics: large (> 10 cm), high-grade, deep, completely resected primary extremity STS (n = 47). Patients in the first group remained disease free (no evidence of disease [NED]) after primary tumor treatment (n = 19), whereas patients in the second group subsequently died of disease (DOD; n = 28). Triplicate 0.6-mm core biopsies from defined morphologic areas of paraffin embedded primary tumors were assembled on a tissue microarray and analyzed by immunohistochemistry with the MIB-1 antibody, and Ki-67 proliferative indices were correlated with patient outcome. RESULTS. High Ki-67 proliferative index, defined as greater than 30% tumor cells showing nuclear immunoreactivity, was significantly more frequent in the DOD group than in the NED group and was associated with tumor-related mortality (P = 0.02). This marker identifies an especially aggressive malignant phenotype within a cohort of high-risk tumors that is based on well established clinical and pathologic parameters alone and is easy to use in a clinical setting. CONCLUSIONS. On the basis of these data and previous reports, high Ki-67 proliferative index is suggested as a significant factor for predicting the prognosis of patients with high-risk STS and should be evaluated prospectively based on clinical trials. © 2001 American Cancer Society.
Keywords: immunohistochemistry; survival; adult; cancer survival; human tissue; aged; aged, 80 and over; middle aged; survival analysis; ki 67 antigen; ki-67 antigen; phenotype; immunoreactivity; cancer mortality; high risk patient; sarcoma; soft tissue sarcoma; humans; prognosis; human; male; female; priority journal; article; ki-67, mib-1
Journal Title: Cancer
Volume: 92
Issue: 4
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2001-08-01
Start Page: 869
End Page: 874
Language: English
DOI: 10.1002/1097-0142(20010815)92:4<869::aid-cncr1395>3.0.co;2-u
PUBMED: 11550160
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Murray F Brennan
    781 Brennan
  2. David Polsky
    12 Polsky
  3. Axel Hoos
    28 Hoos
  4. Marshall   Urist
    9 Urist