TY - JOUR
T1 - Ki-67 as a Prognostic Marker in Upper Urinary Tract Urothelial Carcinoma
T2 - A Systematic Review and Meta-Analysis
AU - Ahn, Chihyun
AU - Jeong, Chang Wook
AU - Kwak, Cheol
AU - Kim, Hyeon Hoe
AU - Kim, Hyung Suk
AU - Ku, Ja Hyeon
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/8
Y1 - 2018/8
N2 - Ki-67 expression has been extensively investigated as a potential prognostic marker in upper tract urothelial carcinoma (UTUC). However, there were conflicting results among previous studies. As a result of the present meta-analysis, overexpression of Ki-67 showed close correlation with poor survival outcomes. Therefore, Ki-67 might be used as a valuable marker to predict prognosis of UTUC patients after surgery. Background: We systematically evaluated the prognostic significance of Ki-67 on survival outcomes in patients with upper urinary tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). Materials and Methods: We searched the Embase, Scopus, and PubMed databases for all articles published up to February 2017 by following the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. The outcomes of interest included intravesical recurrence (IVR)-free survival, disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS). The associations between Ki-67 and the survival outcomes were expressed using a pooled hazard ratio (HR) and a 95% confidence interval (CI). Results: A total of 12 articles, representing 1351 patients with a range from 37 to 475, met the eligibility criteria and were finally selected for this meta-analysis. The overexpression of Ki-67 was significantly associated with worse DFS (HR, 2.74; 95% CI, 1.58-4.74), CSS (HR, 2.26; 95% CI, 1.70-3.01), and OS (HR, 3.71; 95% CI, 1.78-7.75), but not IVR-free survival (HR, 0.77; 95% CI, 0.10-5.82). Interstudy heterogeneity was observed in the analysis of DFS (I2 = 54%; P =.05) and IVR-free survival (I2 = 81%; P =.005). The funnel plot test indicated no significant publication bias in the meta-analysis of survival outcomes. Conclusion: The results drawn in this meta-analysis suggest that the overexpression of Ki-67 might be a promising prognostic indicator predicting survival outcomes after RNU for UTUC. However, a large, well designed, prospective study is necessary to establish the prognostic value of Ki-67 in UTUC.
AB - Ki-67 expression has been extensively investigated as a potential prognostic marker in upper tract urothelial carcinoma (UTUC). However, there were conflicting results among previous studies. As a result of the present meta-analysis, overexpression of Ki-67 showed close correlation with poor survival outcomes. Therefore, Ki-67 might be used as a valuable marker to predict prognosis of UTUC patients after surgery. Background: We systematically evaluated the prognostic significance of Ki-67 on survival outcomes in patients with upper urinary tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). Materials and Methods: We searched the Embase, Scopus, and PubMed databases for all articles published up to February 2017 by following the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. The outcomes of interest included intravesical recurrence (IVR)-free survival, disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS). The associations between Ki-67 and the survival outcomes were expressed using a pooled hazard ratio (HR) and a 95% confidence interval (CI). Results: A total of 12 articles, representing 1351 patients with a range from 37 to 475, met the eligibility criteria and were finally selected for this meta-analysis. The overexpression of Ki-67 was significantly associated with worse DFS (HR, 2.74; 95% CI, 1.58-4.74), CSS (HR, 2.26; 95% CI, 1.70-3.01), and OS (HR, 3.71; 95% CI, 1.78-7.75), but not IVR-free survival (HR, 0.77; 95% CI, 0.10-5.82). Interstudy heterogeneity was observed in the analysis of DFS (I2 = 54%; P =.05) and IVR-free survival (I2 = 81%; P =.005). The funnel plot test indicated no significant publication bias in the meta-analysis of survival outcomes. Conclusion: The results drawn in this meta-analysis suggest that the overexpression of Ki-67 might be a promising prognostic indicator predicting survival outcomes after RNU for UTUC. However, a large, well designed, prospective study is necessary to establish the prognostic value of Ki-67 in UTUC.
KW - Ki-67 antigen
KW - Prognosis
KW - Renal pelvis
KW - Transitional cell carcinoma
KW - Ureter
UR - http://www.scopus.com/inward/record.url?scp=85043790056&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2018.02.010
DO - 10.1016/j.clgc.2018.02.010
M3 - Article
C2 - 29551582
AN - SCOPUS:85043790056
SN - 1558-7673
VL - 16
SP - e831-e841
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 4
ER -