title: Ki-67 and vascular endothelial growth factor expression in uterine leiomyosarcoma.
abstract: OBJECTIVE
  Uterine leiomyosarcomas (LMS) are rare female neoplasms of high malignant potential. The importance of different prognostic parameters in these malignancies remains controversial. The aim of the present study was to evaluate the prognostic value of Ki-67 and vascular endothelial growth factor (VEGF) in uterine LMS.
  
  
  METHODS
  Ki-67 and VEGF expression was assessed using immunohistochemistry from paraffin-embedded tissue in 20 patients with uterine LMS.
  
  
  RESULTS
  Ki-67 was expressed in 10 of 20 cases (50%) of uterine LMS. A statistically significant positive correlation was observed between vascular space involvement and Ki-67 expression (P = 0.05). There was no statistically significant relationship between Ki-67 expression and clinical stage (P = 0.38), recurrent disease (P = 0.86), and age (P = 1.0). An expression of VEGF could be observed in 1 of 20 (5%) cases. The median disease-free survival was 13 months (range: 3-23 months). Eleven (55%) patients died of the disease with a median overall survival of 47.4 months (range: 1-227 months), resulting in a 5-year-overall survival rate of 45%. In a univariate analysis a statistically significant shortened disease-free survival in patients with Ki-67 positive tumors could be observed (P = 0.01).
  
  
  CONCLUSIONS
  Our results suggest that the significant expression of Ki-67 in uterine LMS, correlating with vascular space involvement and being associated with a shortened disease-free survival, may be an indicator of the biological aggressiveness of these rare tumors.
authors.affiliation: Department of Gynecology and Obstetrics, University of Vienna Medical School, Vienna, Austria. klaus.mayerhofer@akh-wien.ac.at
authors.forename: Klaus
authors.initials: K
authors.lastname: Mayerhofer
authors.forename: Plamen
authors.initials: P
authors.lastname: Lozanov
authors.forename: Klaus
authors.initials: K
authors.lastname: Bodner
authors.forename: Barbara
authors.initials: B
authors.lastname: Bodner-Adler
authors.forename: Andreas
authors.initials: A
authors.lastname: Obermair
authors.forename: Oliver
authors.initials: O
authors.lastname: Kimberger
authors.forename: Klaus
authors.initials: K
authors.lastname: Czerwenka
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000096:biosynthesis*; D007890:Leiomyosarcoma / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged; D016612:Paraffin Embedding; D011379:Prognosis; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000378:metabolism* / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000096:biosynthesis*
chemical_list: D019394:Ki-67 Antigen; D042461:Vascular Endothelial Growth Factor A