title: Ki-67 labeling index is associated with recurrence after segmentectomy under video-assisted thoracoscopic surgery in stage I non-small cell lung cancer.
abstract: OBJECTIVE
  Video-assisted thoracoscopic surgery (VATS) segmentectomy for small or early stage non-small cell lung cancer (NSCLC) remains controversial. Here, we investigated the clinical importance of predicting recurrence by Ki-67 in VATS segmentectomy for stage I NSCLC.
  
  
  METHODS
  In a retrospective study, 44 consecutive patients in p-stage I underwent VATS segmentectomy between September 2003 and April 2009. After clinicopathological factors were compared with Ki-67 expression, the relationship between Ki-67 labeling indexes (LI) or mRNA expression by quantitative RT-PCR and prognosis was investigated.
  
  
  RESULTS
  Five of 44 VATS segmentectomy patients relapsed. In the relapsed patients, 3 (6.8%) were local recurrences and 2 (4.5%) were distant metastases. There was no significant difference between clinicopathological factors and recurrence; however, patients with Ki-67 LI less than 5% showed better disease-free survival than patients with Ki-67 LI over 5% (p = 0.04). In multivariate Cox regression analysis, although there was no significantly different in disease-free survival by age, histology, tumor size, only Ki-67 LI showed a significant prognostic factor of recurrence (HR = 12.5, 95% CI = [1.1-1407], p = 0.04).
  
  
  CONCLUSIONS
  Ki-67 LI after VATS segmentectomy was a prognostic factor of disease-free survival in NSCLC and the treatment of choice for patients with positive LI may be considered, in addition to adjuvant chemotherapy, or lobectomy.
authors: Department of Surgery II, Faculty of Medicine, Oita University, Yufu, Oita, Japan. yamashi1@med.oita-u.ac.jp
authors: Shin-ichi
authors: S
authors: Yamashita
authors: Toshihiko
authors: T
authors: Moroga
authors: Keita
authors: K
authors: Tokuishi
authors: Michiyo
authors: M
authors: Miyawaki
authors: Masao
authors: M
authors: Chujo
authors: Satoshi
authors: S
authors: Yamamoto
authors: Katsunobu
authors: K
authors: Kawahara
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000032:analysis* / Q000235:genetics; D008175:Lung Neoplasms / Q000737:chemistry / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018579:Patient Selection; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016133:Polymerase Chain Reaction; D016016:Proportional Hazards Models; D012333:RNA, Messenger / Q000032:analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019394:Ki-67 Antigen; D012333:RNA, Messenger