HOUT-05. INVESTIGATION OF Ki-67 PROLIFERATIVE INDEX AND PATIENT SURVIVAL IN GLIOBLASTOMA MULTIFORME. (5th November 2018)

• Record Type: Journal Article
• Authors: Ravindra, Lakshmi; Carr, Matthew; Dincer, Alper; Zhang, Fan; Donahue, Erin; Rodriguez, Viviana; Rock, Andrew; Opalak, Charles; Somasundaram, Aravind; Workman, Kathryn; Richard, Hope; Sima, Adam; Broaddus, William
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 6
• Page Start: vi113
• Page End: vi114
• Publication Date: 2018-11-05
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy148.473
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: INTRODUCTION: Glioblastoma multiforme (GBM) is a rapidly growing, aggressive brain tumor. Studies demonstrate that higher Ki-67 proliferative indices predict poorer survival in GBM patients. It remains unclear whether therapeutic responses vary when stratifying patients by Ki-67 index. Our objective was to investigate the relationship between Ki-67 index and post-surgical survival in patients with GBM undergoing radiotherapy and/or chemotherapy. METHODS: Patients with GBM presenting to VCU Health between January 2005-February 2015 were retrospectively reviewed. Inclusion criteria were: 1) Age > 18, 2) Biopsy/surgery with histopathological testing, 3) Reported Ki-67 index, and 4) Initial T2 post-contrast tumor volumes. Ki-67 indices were stratified into three groups: Ki-67 ≤ 10, 10 < Ki-67 ≤ 20, and Ki-67 > 20. The primary outcome was overall survival, calculated as time between surgery and death. Cox proportional hazards regression compared the relationship between Ki-67 index and overall survival after controlling for age, sex, race, marital status, medical comorbidities, initial T2 tumor volume, radiotherapy and chemotherapy. RESULTS: There were 69 patients in the study. Demographics, comorbidities, radiotherapy and chemotherapy did not differ between Ki-67 groups. Median survival time (weeks) was 61.7 (32.9–132.6), 34.9 (13.6–84.9), and 39.3 (16.7–84.1) for Ki-67 ≤ 10, 10 < Ki-67 ≤ 20, and Ki-67 > 20 groups, respectively. There was no significant difference in survival between Ki-67 groups in unadjusted (p=0.69) or adjusted analyses (p=0.83). However, older age (1.06 hazard ratio, 1.01–1.11 CI, 0.01 p-value), radiotherapy (91.5, 4.38-1911.27, 0.004), arthritis (7.81, 1.30–46.79, 0.03), diabetes (7.22, 42.14, 0.03), and hypercholesterolemia (15.76, 3.40–72.97, < 0.001) were associated with shorter survival. CONCLUSIONS: This study demonstrated no relationship between Ki-67 index and survival in patients with GBM when controlling for other factors, but highlighted factors related to poorer survival (older age, radiotherapy, arthritis, diabetes, hypercholesterolemia). Further prospective studies on the association between survival and Ki-67 index in a larger cohort of patients with GBM are warranted.