Document Detail

Ki-67 is an independent predictor of bladder cancer outcome in patients treated with radical cystectomy for organ-confined disease.
MedLine Citation:
PMID:  17189409     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To determine the association of the cell proliferative marker Ki-67 with pathologic features and disease prognosis in patients with transitional cell carcinoma (TCC) of the urinary bladder.
METHODS: Immunohistochemical staining for Ki-67 was done on serial cuts from tissue microarrays containing cystectomy specimens from 9 patients without bladder cancer and 226 consecutive patients with bladder TCC. We also assessed malignant lymph nodes from 50 of the 226 cystectomy patients.
RESULTS: Ki-67 expression was increased in 42.5% cystectomy specimens and in 54% metastatic lymph nodes. In contrast, it was absent in all nine benign cystectomy specimens. Ki-67 overexpression was associated with advanced pathologic stage, higher grade, lymphovascular invasion, and metastases to lymph nodes (P = 0.001, 0.040, 0.031, and 0.036, respectively). In multivariate analyses, pathologic stage and lymph node metastases were independent predictors of disease recurrence and bladder cancer-specific mortality. In the subgroup of patients with organ-confined disease (<pT(3) N(0); n = 91), excluding patients who received neoadjuvant or adjuvant chemotherapy, Ki-67 status was an independent predictor of both disease recurrence (risk ratio, 7.591; P = 0.001) and bladder cancer-specific mortality (risk ratio, 4.045; P = 0.041).
CONCLUSIONS: Ki-67 overexpression is associated with features of aggressive bladder TCC and adds independent prognostic information to standard pathologic features for prediction of clinical outcome after radical cystectomy.
Vitaly Margulis; Shahrokh F Shariat; Raheela Ashfaq; Arthur I Sagalowsky; Yair Lotan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cancer research : an official journal of the American Association for Cancer Research     Volume:  12     ISSN:  1078-0432     ISO Abbreviation:  Clin. Cancer Res.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-25     Completed Date:  2007-03-15     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  9502500     Medline TA:  Clin Cancer Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  7369-73     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Carcinoma, Transitional Cell / diagnosis*,  mortality,  pathology,  surgery*
Cystectomy / statistics & numerical data
Disease-Free Survival
Gene Expression Regulation, Neoplastic
Ki-67 Antigen / metabolism,  physiology*
Lymphatic Metastasis / diagnosis,  pathology
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local / diagnosis,  mortality
Neoplasm Staging
Survival Analysis
Treatment Outcome
Tumor Markers, Biological / physiology
Urinary Bladder Neoplasms / diagnosis*,  mortality,  pathology,  surgery*
Reg. No./Substance:
0/Ki-67 Antigen; 0/Tumor Markers, Biological

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