The Ki-67 labeling index as a prognostic factor in Grade II oligoastrocytomas.
OBJECTIVE
This study was conducted to determine whether proliferative tumor activity, as assessed using the Ki-67 immunohistochemical labeling index (LI), has prognostic utility for patients with Grade II oligoastrocytomas.


METHODS
The study period spans the years 1988 to 2000. In a retrospective analysis, the authors selected cases with biopsy-proven diagnoses of Grade II oligoastrocytomas on initial presentation. The authors added new patients to this group and followed all patients prospectively at the University of Virginia Neuro-Oncology Center. Twenty-three adult patients were followed for at least 1 year (median 40.3 months). Eleven patients with Grade II tumors and initial Ki-67 LIs less than 10% had a significantly longer median time to tumor progression (TTP, 51.8 months compared with 9.9 months) and a longer median survival (93.1 months compared with 16.1 months) than 12 patients with initial Ki-67 LIs of 10% or greater. Twelve patients with Grade III oligoastrocytomas had a mean TTP that was similar to the TTP of patients with Grade II tumors and high Ki-67 LIs (mean 4 months compared with 9.9 months) and duration of survival (13.3 months compared with 16.1 months).


CONCLUSIONS
Patients with a Grade II oligoastrocytoma and a Ki-67 LI of 10% or greater have a much shorter TTP and potentially a poorer disease prognosis than expected--more similar to patients with a Grade III oligoastrocytoma. These results indicate that in the future a measure of proliferative activity should be taken into consideration along with the World Health Organization grading criteria for oligoastrocytomas.
Shaffrey
Mark E
ME
Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA.
Farace
Elana
E
Schiff
David
D
Larner
James M
JM
Mut
Melike
M
Lopes
M Beatriz S
MB
D000328:Adult; D017677:Age Distribution; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001254:Astrocytoma / Q000378:metabolism* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D014408:Biomarkers, Tumor; D001932:Brain Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011878:Radiotherapy; D012189:Retrospective Studies; D016019:Survival Analysis
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen