Ki67 does not predict recurrence for low-grade appendiceal mucinous neoplasms with peritoneal dissemination after cytoreductive surgery and HIPEC

Autor: Sohini Khan, Jula Veerapong, Kaitlyn J. Kelly, Andrew M. Lowy, Morgan Hosseini, Luke Okamuro, Mark A. Valasek, Erin P. Ward, Nemencio Ronquillo, Joel M. Baumgartner
Rok vydání: 2021
Předmět:
0301 basic medicine
Adult
Male
medicine.medical_specialty
Multivariate analysis
Time Factors
Databases
Factual
Patient characteristics
Hyperthermic Intraperitoneal Chemotherapy
Gastroenterology
Risk Assessment
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Mucinous carcinoma
Humans
Peritoneal Neoplasms
Aged
Retrospective Studies
Aged
80 and over
Univariate analysis
business.industry
Cytoreduction Surgical Procedures
Middle Aged
medicine.disease
Adenocarcinoma
Mucinous
Progression-Free Survival
030104 developmental biology
Ki-67 Antigen
Appendiceal Neoplasms
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Cohort
Peritoneal Cancer Index
Hyperthermic intraperitoneal chemotherapy
Female
Neoplasm Grading
Neoplasm Recurrence
Local
Cytoreductive surgery
business
Zdroj: Human pathology. 113
ISSN: 1532-8392
Popis: Summary Low-grade appendiceal mucinous neoplasms (LAMN) can disseminate to become low-grade mucinous carcinoma peritonei (LGMCP), which is optimally treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Approximately half of the patients with LGMCP recur despite complete cytoreduction, and risk factors for recurrence are poorly understood. We sought to evaluate if Ki67 predicts progression of LGMCP after CRS/HIPEC. A retrospective review of a prospectively maintained database was performed to identify patients treated with complete CRS/HIPEC for LGMCP from 2008 to 2019 with Ki67 assessed. Patient characteristics, histologic data, average and focally high “hotspot”) Ki67 index, progression-free survival (PFS), and overall survival (OS) were analyzed. Ki-67 immunostain was performed on the histologic section with the highest cellularity and architectural complexity. Forty-four patients with LGMCP (55% male, median age 61) were identified. The median Ki67 score and hotspot Ki67 score was 15% (1–70) and 50% (1–90), respectively. On univariate analysis, average Ki67 and hotspot Ki67 were not predictive of PFS when analyzed as continuous normalized values (HR 1.0, p = 0.79 and HR 1.1, p = 0.38, respectively) or as categorical values when stratified by the median (HR 0.9, p = 0.67 and HR 1.0, p = 0.93). This remained true on multivariate analysis when stratified for peritoneal cancer index, CEA, and completeness of cytoreduction score for both normalized Ki67 and hotspot Ki67 (HR 0.9 [95% CI 0.8–1.3], p = 0.94 and HR 1.04 [95% CI 0.8–1.3], p = 0.73, respectively). Ki67 failed to predict disease recurrence for patients with LGMCP in this cohort.
Databáze: OpenAIRE
Externí odkaz: