M. Shiba et al., Prognostic implication of Ki-67 immunostaining in treating subclinical pleural cancer found at thoracotomy in lung cancer patients, ANN THORAC, 71(6), 2001, pp. 1765-1771
Citations number
20
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. Therapeutic principles for managing subclinical pleural cancer
found unexpectedly during intraoperative examination are unclear. We analyz
ed prognostic factors including the tumor proliferative marker Ki-67 in the
se circumstances.
Methods. The cases of 65 surgically treated patients with lung cancer and s
ubclinical T4 pleural cancer, microscopic in 25 and macroscopic in 40, were
reviewed.
Results. The overall 5-year survival rate of patients undergoing lobectomy
was 14.3%. For patients with T4 NO disease, the 5-year survival rate was 46
.7%. In patients with a low Ki-67 labeling index, the 5-year survival rate
was 28.6%. The Ki-67 labeling index was a significant (p < 0.05) indicator
of survival. Multivariate analysis demonstrated Ki-67 labeling index, lymph
node involvement, and tumor differentiation to be the most influential pro
gnostic factors for postoperative survival (p < 0.01).
Conclusions. In the treatment of lung cancer patients with subclinical pleu
ral cancer found at thoracotomy, tumor resection is not necessarily contrai
ndicated. Resection appears to be beneficial in patients with no nodal invo
lvement or a low tumor Ki-67 labeling index. This index is a good therapeut
ic indicator for lung cancer patients.