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Prospective evaluation of Ki-67 system in histological grading of soft tissue sarcomas in the Japan Clinical Oncology Group Study JCOG0304.

Tanaka K, Hasegawa T, Nojima T, Oda Y, Mizusawa J, Fukuda H, Iwamoto Y - World J Surg Oncol (2016)

Bottom Line: The correct clinical staging of soft tissue sarcomas (STS) is critical for the selection of treatments.The reproducibility of Ki-67 grading system in the histological grading of STS was higher than FNCLCC system (κ = 0.54 [95 % CI 0.39-0.71], and 0.46 [0.32-0.62], respectively).Although FNCLCC grade was not associated with overall survival (OS) in univariate analysis (HR 2.80 [0.74-10.55], p = 0.13), Ki-67 grading system had a tendency to associate with OS in univariate analysis (HR 4.12 [0.89-19.09], p = 0.07) and multivariate analysis with backward elimination (HR 3.51 [0.75-16.36], p = 0.11).

View Article: PubMed Central - PubMed

Affiliation: Department of Endoprosthetic Surgery, Oita University, Yufu, Oita, 879-5593, Japan.

ABSTRACT

Background: The correct clinical staging of soft tissue sarcomas (STS) is critical for the selection of treatments. The staging system consists of histological grade of the tumors and French Federation of Cancer Center (FNCLCC) system based on mitotic count is widely used for the grading. In this study, we compared the validity and usefulness of Ki-67 grading system with FNCLCC system in JCOG0304 trial which investigated the efficacy and safety of perioperative chemotherapy with doxorubicin and ifosfamide for STS.

Methods: All 70 eligible patients with STS in the extremities treated by perioperative chemotherapy in JCOG0304 were analyzed. Univariate and multivariate Cox regression analyses were conducted to investigate an influence on overall survival.

Results: The reproducibility of Ki-67 grading system in the histological grading of STS was higher than FNCLCC system (κ = 0.54 [95 % CI 0.39-0.71], and 0.46 [0.32-0.62], respectively). Although FNCLCC grade was not associated with overall survival (OS) in univariate analysis (HR 2.80 [0.74-10.55], p = 0.13), Ki-67 grading system had a tendency to associate with OS in univariate analysis (HR 4.12 [0.89-19.09], p = 0.07) and multivariate analysis with backward elimination (HR 3.51 [0.75-16.36], p = 0.11).

Conclusions: This is the first report demonstrating the efficacy of Ki-67 grading system for the patients with STS in the prospective trial. The results indicate that Ki-67 grading system might be useful for the evaluation of histological grade of STS.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier estimates of overall survival by FNCLCC grading (n = 70)
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Fig2: Kaplan-Meier estimates of overall survival by FNCLCC grading (n = 70)

Mentions: With a median follow-up of 3.6 years for 70 eligible patients included in this study, the proportion of 2-year and 5-year OS for the included patients in the present analysis (n = 70) was 91.4 % (95 % CI, 81.9–96.1 %) and 81.8 % (95 % CI, 68.9–89.7 %), respectively. There were no significant differences in survival regarding age (<50 vs. ≥50), sex (male vs. female), tumor size (<10 vs. ≥10 cm, or <8 vs. ≥8 cm), histological subtypes (UPS vs. synovial sarcoma vs. others), histological tumor differentiation (score 2 vs. 3), tumor necrosis (score 2 vs. 3), and mitosis (score 1 vs. 2 vs. 3) (Table 4). There was also no significant difference between survival of the patients with FNCLCC grade 2 tumors (5-year OS 90.9 %, [95 % CI 74.3–97.0]) and that with grade 3 tumors (5-year OS 73.5 %, [95 % CI 53.2–86.1]) (HR 2.80, 95 % CI 0.74–10.55, p = 0.13) (Fig. 2). However, survival of the patients with the tumor assessed as histologic grade 3 by Ki-67 immunostaining was worse than that with the tumor assessed as grade 2. The 5-year OS for grade 3 and grade 2 tumors using Ki-67 was 73.5 % (95 % CI 54.4–85.6) (n = 38) and 91.8 % (95 % CI 69.8–98.0) (n = 32), respectively (HR 4.12, 95 % CI 0.89–19.09, p = 0.070) (Fig. 3, Table 4). While FNCLCC grading system was not selected as a prognostic factor by multivariate analysis with backward elimination, Ki-67 grading system was also tended to associate with OS on multivariate analysis with backward elimination (HR 3.51, 95 % CI 0.75–16.36, p = 0.11) (Table 5).Table 4


Prospective evaluation of Ki-67 system in histological grading of soft tissue sarcomas in the Japan Clinical Oncology Group Study JCOG0304.

Tanaka K, Hasegawa T, Nojima T, Oda Y, Mizusawa J, Fukuda H, Iwamoto Y - World J Surg Oncol (2016)

Kaplan-Meier estimates of overall survival by FNCLCC grading (n = 70)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4836080&req=5

Fig2: Kaplan-Meier estimates of overall survival by FNCLCC grading (n = 70)
Mentions: With a median follow-up of 3.6 years for 70 eligible patients included in this study, the proportion of 2-year and 5-year OS for the included patients in the present analysis (n = 70) was 91.4 % (95 % CI, 81.9–96.1 %) and 81.8 % (95 % CI, 68.9–89.7 %), respectively. There were no significant differences in survival regarding age (<50 vs. ≥50), sex (male vs. female), tumor size (<10 vs. ≥10 cm, or <8 vs. ≥8 cm), histological subtypes (UPS vs. synovial sarcoma vs. others), histological tumor differentiation (score 2 vs. 3), tumor necrosis (score 2 vs. 3), and mitosis (score 1 vs. 2 vs. 3) (Table 4). There was also no significant difference between survival of the patients with FNCLCC grade 2 tumors (5-year OS 90.9 %, [95 % CI 74.3–97.0]) and that with grade 3 tumors (5-year OS 73.5 %, [95 % CI 53.2–86.1]) (HR 2.80, 95 % CI 0.74–10.55, p = 0.13) (Fig. 2). However, survival of the patients with the tumor assessed as histologic grade 3 by Ki-67 immunostaining was worse than that with the tumor assessed as grade 2. The 5-year OS for grade 3 and grade 2 tumors using Ki-67 was 73.5 % (95 % CI 54.4–85.6) (n = 38) and 91.8 % (95 % CI 69.8–98.0) (n = 32), respectively (HR 4.12, 95 % CI 0.89–19.09, p = 0.070) (Fig. 3, Table 4). While FNCLCC grading system was not selected as a prognostic factor by multivariate analysis with backward elimination, Ki-67 grading system was also tended to associate with OS on multivariate analysis with backward elimination (HR 3.51, 95 % CI 0.75–16.36, p = 0.11) (Table 5).Table 4

Bottom Line: The correct clinical staging of soft tissue sarcomas (STS) is critical for the selection of treatments.The reproducibility of Ki-67 grading system in the histological grading of STS was higher than FNCLCC system (κ = 0.54 [95 % CI 0.39-0.71], and 0.46 [0.32-0.62], respectively).Although FNCLCC grade was not associated with overall survival (OS) in univariate analysis (HR 2.80 [0.74-10.55], p = 0.13), Ki-67 grading system had a tendency to associate with OS in univariate analysis (HR 4.12 [0.89-19.09], p = 0.07) and multivariate analysis with backward elimination (HR 3.51 [0.75-16.36], p = 0.11).

View Article: PubMed Central - PubMed

Affiliation: Department of Endoprosthetic Surgery, Oita University, Yufu, Oita, 879-5593, Japan.

ABSTRACT

Background: The correct clinical staging of soft tissue sarcomas (STS) is critical for the selection of treatments. The staging system consists of histological grade of the tumors and French Federation of Cancer Center (FNCLCC) system based on mitotic count is widely used for the grading. In this study, we compared the validity and usefulness of Ki-67 grading system with FNCLCC system in JCOG0304 trial which investigated the efficacy and safety of perioperative chemotherapy with doxorubicin and ifosfamide for STS.

Methods: All 70 eligible patients with STS in the extremities treated by perioperative chemotherapy in JCOG0304 were analyzed. Univariate and multivariate Cox regression analyses were conducted to investigate an influence on overall survival.

Results: The reproducibility of Ki-67 grading system in the histological grading of STS was higher than FNCLCC system (κ = 0.54 [95 % CI 0.39-0.71], and 0.46 [0.32-0.62], respectively). Although FNCLCC grade was not associated with overall survival (OS) in univariate analysis (HR 2.80 [0.74-10.55], p = 0.13), Ki-67 grading system had a tendency to associate with OS in univariate analysis (HR 4.12 [0.89-19.09], p = 0.07) and multivariate analysis with backward elimination (HR 3.51 [0.75-16.36], p = 0.11).

Conclusions: This is the first report demonstrating the efficacy of Ki-67 grading system for the patients with STS in the prospective trial. The results indicate that Ki-67 grading system might be useful for the evaluation of histological grade of STS.

No MeSH data available.


Related in: MedlinePlus