Küratif Radyoterapi ile Tedavi Edilmiş Erken Evre Glottik Larinks Kanserinde Ki-67'nin Prognostik Önemi

Abstract

Amaç: Erken evre glottik larinks kanserinde Ki-67 ekspresyonunun prognostik önemi halen tartışmalıdır. Bu çalışmada küratif radyoterapi ile tedavi edilmiş erken evre glottik larinks kanserde Ki-67 ekspresyonunun prognostik önemini değerlendirmek amaçlanmıştır. Metod: 2010-2021 yılları arasında kliniğimizde küratif radyoterapi ile tedavi edilmiş T1a/bN0 hastalar tespit edildikten sonra olgular geriye dönük olarak tek bir patolog tarafından Ki-67 ekspresyonu açısından yeniden değerlendirilmiştir. ROC eğrisine göre Ki-67 için optimal cut-off değeri %35 tespit edilmesi nedeniyle bu eşik noktasının üstü yüksek ekspresyon (Ki-67-yüksek), altı ise düşük ekspresyon (Ki-67-düşük) olarak kabul edilmiştir. Bulgular: Küratif radyoterapi ile tedavi edilmiş toplam 49 hasta analize dahil edildi. Ortanca takip süresi 35,74 (7,03-161,65) ay idi. Ortanca genel sağkalım süresi (GS) 95,4 (62,1-128,8) ay idi. Tek değişkenli analize göre, tümör gradı (p=0.006) ve Ki-67 ekspresyon düzeyi (p=0.039) GS’yi öngören anlamlı prognostik faktörler olarak saptandı. Ortanca hastalıksız sağkalım süresi (HSS) 42,1 (32,8-51,3) ay idi. Tek değişkenli analizlere göre, tümör gradı (p=0.008) ve Ki-67 ekspresyon düzeyi (p=0.007), HSS’yi öngören anlamlı prognostik faktörler olarak bulundu. Sonuç: Ki-67 ekspresyonu sağkalımı öngörebilecek prognostik bir belirteç olarak bulunmuş olup yüksek ekspresyon düzeyi daha düşük GS ve HSS ile ilişkilendirilmiştir. Ki-67 ekspresyon seviyesi, bu hastalarda tedavi seçimini belirlemek için bir biyobelirteç olarak kullanılabilir. Sonuçlarımızı doğrulamak için daha fazla hasta ile ek prospektif çalışmalara ihtiyaç vardır.

Keywords

• Larinks Kanseri
• Ki-67
• Sağkalım Sonuçları
• Radyoterapi

Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated with Radiotherapy

Abstract

Objective: The prognostic importance of Ki-67 expression in early-stage glottic larynx cancer is controversial. In this study, we aimed to evaluate the prognostic importance of Ki-67 expression in early-stage glottic cancer treated with curative radiotherapy at a single centre. Material and Method: Between 2010 and 2021, patients with T1a/bN0 stage glottic larynx cancer treated with curative radiotherapy were identified. The cases included in this study were re-evaluated by a single pathologist retrospectively. According to the ROC curve, the optimal cut-off value was 35% for Ki-67. Above these cut-off points were accepted as high expression levels (Ki-67-high), while below these points were accepted as low expression levels (Ki-67-low). Results: A total of 49 patients with early-stage glottic larynx cancer treated with definitive radiotherapy were included. The median follow-up time was 35.74 (range; 7.03-161.65) months. The median OS was 95.4 (range; 62.1-128.8) months. According to univariate analysis, tumour grade (p=0.006) and Ki-67 expression level (low vs high; p=0.039) were the prognostic factors that predict OS. The median DFS was 42.1 (range; 32.8-51.3) months. According to univariate analyses, tumour grade (p=0.008) and Ki-67 expression level (low vs high; p=0.007) were the prognostic factors that predict DFS. Conclusion: Higher Ki-67 expression was associated with lower OS and DFS. Ki-67 expression level can be used as a biomarker to determine treatment choice in these patients. Additional prospective studies with more patients are needed to confirm our results.

Keywords

• Larynx Cancer
• Ki-67
• survival outcomes
• radiotherapy

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