Prognostic factors for keratocystic odontogenic tumor (odontogenic keratocyst): analysis of clinico-pathologic and immunohistochemical findings in cysts treated by enucleation.
BACKGROUND
The purpose of this study was to determine prognostic factors for the recurrence of keratocystic odontogenic tumors (KCOTs) following simple enucleation by examining clinico-pathologic and immunohistochemical findings.


METHODS
Following enucleation, the frequency of recurrence among 32 subjects diagnosed with KCOT was analyzed for tumor site, radiographic and histologic features, and immunopositivity for Ki-67 and p53.


RESULTS
Keratocystic odontogenic tumors in four out of 32 subjects (12.5%) recurred during the follow-up period (median: 33 months, range: 7-114 months). Three out of four subjects (75.0%) among recurrent group showed high expression of Ki-67 (LI >10%) in basal layer and four (4/28; 14.3%) among non-recurrence group (P = 0.025). Expression of p53 among non-recurrent group was observed in 11 subjects (11/28; 39.3%), and in three subjects (3/4; 75.0%) among the recurrent group (P = 0.295). Hazard risk for the recurrence of KCOT was 4.02 (95% CI 1.42-18.14) for high Ki-67 expression in the basal layer by the Cox proportional hazard model (P = 0.009). In our study, none of the other clinico-pathologic variables were associated with the recurrence of KCOT.


CONCLUSIONS
The results suggested that the evaluation of Ki-67 expression in KCOT at the time of pathological diagnosis might be helpful for consideration of appropriate adjunctive surgical procedures to avoid a recurrence and may serve as a prognostic marker.
Kuroyanagi
Norio
N
Department of Maxillofacial Surgery, Aichi-Gakuin University School of Dentistry, Aichi, Japan.
Sakuma
Hidenori
H
Miyabe
Satoru
S
Machida
Junichiro
J
Kaetsu
Atsuo
A
Yokoi
Motoo
M
Maeda
Hatsuhiko
H
Warnakulasuriya
Saman
S
Nagao
Toru
T
Shimozato
Kazuo
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins; D019394:Ki-67 Antigen / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D009807:Odontogenic Cysts / Q000737:chemistry / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012008:Recurrence; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis; D055815:Young Adult
D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53; D007633:Keratins