Ki67 PROLIFERATION INDEX AS A MARKER FOR CLINICAL RADIORESPONSE IN GLIOBLASTOMA MULTIFORME

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Ki-67 PROLIFERATION INDEX AS A MARKER FOR
CLINICAL RADIORESPONSE IN GLIOBLASTOMA MULTIFORME

• Ufuk Abacioglu1, Berin Güçlüer2, Ilknur Çetin1,
  Züleyha Akgün1, Evrim Tezcanli1, Meriç Sengöz1,
  Aydin Sav3
• 1Marmara University Hospital, Department of
  Radiation Oncology,
• 2Göztepe Research and Education Hospital
  Department of Pathology,
• 3Marmara University Hospital, Department of
  Pathology, Istanbul, Turkey
• Contact ufuka_at_marmara.edu.tr

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PURPOSE

• Studies investigating the proliferation markers
  and outcome of patients with glioblastoma
  multiforme (GBM) have generated controversial
  results.
• Three studies have found a significant
  correlation with increasing Ki-67 proliferation
  index (PI) and poor outcome1-3, while one study
  has demonstrated totally different results4
• In this study, we aimed to assess the prognostic
  significance of Ki-67 proliferation index (PI) in
  a cohort of 85 GBM patients treated with
  postoperative radiotherapy.

1Scott, Ann Neurol, 1999 2McKeever, Neurology,
2001 3Ho, Am J Clin Pathol, 2003 4Bredel, Eur J
Cancer, 2002
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METHODS

• Study period 1997-2004
• 85 GBM patients
• Age median 59 y (22-79 y)
• Female/Male 30/55
• KPS median 80 (30-100)
• Symptom duration median1month (1-84 m)
• Convulsions 27
• Multisentricity 13
• Surgery
• Gross total 43
• Subtotal 29
• St bx 28
• RT dose median 60 Gy (10-72 Gy)

• MIB-1 antibody against Ki-67 nuclear antigene
  (MS-123-R7, Neomarkers) IHC
• Nuclear IHC / 1000 cells

Ki-67 PI 12
Ki-67 PI 96
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RESULTS

• Median Overall Survival 9 ? 1.3 months
• OS_at_1y 37 ? 5.4
• Ki-67 PI median13, mean17.9 (0-96, range)

UVA Univariate analysis, MVA Multivariate
analysis
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RESULTS
Ki-67 gt/ 13 total sx (n20) vs others
Stereotactic Biopsy, n24
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CONCLUSIONS

• In our GBM patients series younger age, surgical
  resection and Ki-67 PI proved to be independent
  prognostic factors for survival.
• Since all patients received radiotherapy, we
  suggest that tumors with a high proliferation
  rate were more responsive to treatment.
• In patients with unresectable GBM, Ki-67 PI
  demonstrated to be a likely predictive factor for
  the selection of a radical or palliative
  treatment approach.