title: Proliferative index activity in oral squamous cell carcinoma: indication for postoperative radiotherapy?
abstract: The predictive value of the Ki-67 labelling index and its relationship with radiosensitivity in oral squamous cell carcinoma (SCC) remains controversial. We sought to evaluate whether the expression of Ki-67 antigen found in SCC of the tongue and the floor of the mouth is an indication for postoperative radiotherapy (PORT). The first study group included 34 patients who were treated only with primary surgery, while the second group included 26 patients who underwent primary surgery combined with PORT. The correlation between Ki-67 expression and loco-regional recurrence, as well as the 5-year disease-specific survival, was assessed in the two groups. Cases of high-proliferative tumours showed a significantly higher risk of loco-regional recurrence (P=0.018) and a poorer prognosis (P=0.001) only in the 34 patients treated with surgery alone. In multivariate Cox regression analysis, high Ki-67 expression was an independent predictor of loco-regional recurrence (HR 5.42, P=0.029) and disease-specific survival (HR 9.02, P=0.004). The correlation between Ki-67 expression and the risk of loco-regional recurrence in SCC of the tongue and the floor of the mouth may be useful in the selection of patients at a higher risk of recurrence who would benefit from PORT, despite adequate margins of resection and early stage of the disease.
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Rydygier Hospital, Cracow, Poland. Electronic address: mgontarz@op.pl.
authors.forename: M
authors.initials: M
authors.lastname: Gontarz
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Rydygier Hospital, Cracow, Poland.
authors.forename: G
authors.initials: G
authors.lastname: Wyszyńska-Pawelec
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Rydygier Hospital, Cracow, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Zapała
authors.affiliation: Department of Pathomorphology, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Czopek
authors.affiliation: Department of Pathomorphology, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Lazar
authors.affiliation: Department of Pathomorphology, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: R
authors.initials: R
authors.lastname: Tomaszewska
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen
keywords: Ki-67 antigen; immunohistochemistry; oral squamous cell carcinoma.; radiotherapy