Back to Program | 2010 Program and Abstracts Overview | 2010 Posters
The Validity of Ki-67 As a Prognostic Indicator in Patients with Appendiceal Carcinoid Tumor
Eric Liu*1, Dana a. Telem1, John Hwang1, Richard R. Warner2, Steven H. Dikman3, Celia M. Divino1
1Surgery, The Mount Sinai Hospital, New York, NY; 2Internal Medicine, The Mount Sinai Medical Center, New York, NY; 3Pathology, The Mount Sinai Medical Center, New York, NY
Purpose: To examine the validity of the growth fraction marker of cell proliferation, ki-67, as a prognostic indicator in patients with appendiceal carcinoid tumors. Method: A retrospective chart review was conducted on 51 patients with appendiceal carcinoid tumors who underwent surgical intervention from 1991 - 2008. MIB-1, a monoclonal antibody of Ki-67 measuring its expression, was used to determine cell proliferation and correlated with clinical and histological parameters. MIB-1 index was categorized according to the WHO (World Health Organization) classification.Result: Of the 51 patients, 41 had MIB index<2%, 6 MIB index between 2-15% and 4 had MIB index >15%. Assessment by tumor size demonstrated, 32 patients had tumors <2cm; 3 >2cm; and 16 tumors were of unspecified size. Patients with tumors < 2cm, were significantly more likely to have MIB index <2% vs. MIB 2%-15% and MIB>15% (84% vs. 12.5% vs. 3%, p<0.001), respectively. For the 3 patients with tumor>2cm, all had MIB index<2%. Twelve patients were discovered to have metastatic disease on presentation. No significant difference was demonstrated by MIB index <2%, 2-15%, or >15%, (22% (9) vs. 17% (1) vs. 50% (2), p=0.68), respectively. Comparison by MIB index of patients with and without metastasis demonstrated the following: MIB <2% (22% vs. 78%, p<0.001), MIB 2-15% (17% vs. 83%, p=0.21), and MIB>15% (50% vs. 50%, p=1.0), respectively. Median follow-up was 40 months (range 10-183 months) with a 51% follow-up rate. Of the 26 patients with follow up, there were 7 mortalities and 3 recurrences. Assessment of survival demonstrated significantly decreased survival by increasing MIB index. Survival rate by MIB index was as follows: <2% was 97%, 2-15% was 85% and >15% was 67% (p=0.02). Conclusion: This study demonstrated significantly decreased survival by increasing MIB index. KI-67 may be a useful prognostic indicator for survival in patients with appenidiceal carcinoid tumors. No correlation between MIB index and tumor size or presentation with metastatic disease was demonstrated.
Back to Program | 2010 Program and Abstracts Overview | 2010 Posters
