Increase of Ki‐67 index and influence on mortality in patients with neuroendocrine neoplasms. (19th August 2021)

• Record Type: Journal Article
• Authors: Holmager, Pernille; Langer, Seppo W.; Federspiel, Birgitte; Willemoe, Gro Linno; Garbyal, Rajendra Singh; Melchior, Linea; Klose, Marianne; Kjaer, Andreas; Hansen, Carsten Palnaes; Andreassen, Mikkel; Knigge, Ulrich
• Is Part Of: Journal of neuroendocrinology. Volume 33:Number 9(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-08-19
• Subjects: Ki‐67 index -- neuroendocrine neoplasms -- prognosis -- progression; Neuroendocrinology -- Periodicals; 616.4
• DOI: 10.1111/jne.13018
• Languages: English
• ISSNs: 0953-8194

Abstract

Abstract: An increase in the Ki‐67 index in neuroendocrine neoplasms over time in relation to prognosis has scarcely been investigated. We aimed to assess whether the Ki‐67 index changed over time and also whether a change influenced prognosis. Second, we investigated the difference in the Ki‐67 index between primary tumour and metastases. From 1 January 1995 to 31 December 2019, 108 consecutive patients with gastroenteropancreatic tumours were included. Patients were followed with regard to an increase in the Ki‐67 index and all‐cause mortality. Ki‐67 determination of the primary tumour at diagnosis and at the time of radiological progression, including developed metastases, was performed. A significant increase in the Ki‐67 index was defined as a doubling of the value at disease progression compared to the value at diagnosis. In addition, in 14 patients, the Ki‐67 index of the primary tumour and present metastases at the time of diagnosis was investigated. At diagnosis, there were no differences in the Ki‐67 index between primary tumours and metastases ( P = .41). Sixty‐five patients had a doubling of the Ki‐67 index. The median Ki‐67 index at the time of progression 17% (1%‐90%) vs 5% (1%‐60%) at the time of diagnosis ( P = .006). A doubling of the Ki‐67 index was independently associated with all‐cause mortality (hazard ratio = 2.7 [1.3‐6.3], P = 0.02), after adjustment for relevant co‐variables including the Ki‐67 index at baseline. Doubling of the Ki‐67 index at the time of disease progression was associated with a significantly higher risk of all‐cause mortality. We recommend that a Ki‐67 index is obtained whenever disease progression is recorded by demonstrated progression because it may have impact on the choice of treatment. Abstract : Association between a doubling and less than a doubling in Ki‐67 index from diagnosis to time for progression and all‐cause mortality.