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Updated: Apr 18, 2026
Implantation and Monitoring by PET/CT of an Orthotopic Model of Human Pleural Mesothelioma in Athymic Mice
Published on: December 21, 2019
Ki67 index is an independent prognostic factor in epithelioid but not in non-epithelioid malignant pleural
B Ghanim1, T Klikovits2, M A Hoda1
11] Department of Surgery, Comprehensive Cancer Center, Division of Thoracic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria [2] Institute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria.
Background:
Estimating the prognosis in malignant pleural mesothelioma (MPM) remains challenging. Thus, the prognostic relevance of Ki67 was studied in MPM.
Methods:
Ki67 index was determined in a test cohort of 187 cases from three centres. The percentage of Ki67-positive tumour cells was correlated with clinical variables and overall survival (OS). The prognostic power of Ki67 index was compared with other prognostic factors and re-evaluated in an independent cohort (n=98).
Results:
Patients with Ki67 higher than median (>15%) had significantly (P<0.001) shorter median OS (7.5 months) than those with low Ki67 (19.1 months). After multivariate survival analyses, Ki67 proved to be-beside histology and treatment-an independent prognostic marker in MPM (hazard ratio (HR): 2.1, P<0.001). Interestingly, Ki67 was prognostic exclusively in epithelioid (P<0.001) but not in non-epithelioid subtype. Furthermore, Ki67 index was significantly lower in post-chemotherapy samples when compared with chemo-naive cases. The prognostic power was comparable to other recently published prognostic factors (CRP, fibrinogen, neutrophil-to-leukocyte ratio (NLR) and nuclear grading score) and was recapitulated in the validation cohort (P=0.048).
Conclusion:
This multicentre study demonstrates that Ki67 is an independent and reproducible prognostic factor in epithelioid but not in non-epithelioid MPM and suggests that induction chemotherapy decreases the proliferative capacity of MPM.
Insights
Ki67 is a reliable prognostic marker for epithelioid malignant pleural mesothelioma (MPM), indicating shorter survival. Chemotherapy may reduce tumor proliferation in MPM patients.
Area of Science:
- Oncology
- Pathology
Background:
- Prognosticating malignant pleural mesothelioma (MPM) is complex.
- The prognostic value of Ki67 in MPM requires further investigation.
Purpose of the Study:
- To evaluate the prognostic relevance of the Ki67 index in MPM.
- To compare Ki67's prognostic power with other established markers.
Main Methods:
- Ki67 index assessed in 187 MPM cases across three centers.
- Correlated Ki67 with clinical variables and overall survival (OS).
- Validated findings in an independent cohort of 98 cases.
Main Results:
- Higher Ki67 index (>15%) correlated with significantly shorter OS (7.5 vs. 19.1 months).
- Ki67 is an independent prognostic marker in MPM, particularly in epithelioid subtype.
- Ki67 index was lower in post-chemotherapy samples, suggesting reduced tumor proliferation.
Conclusions:
- Ki67 is a reproducible, independent prognostic factor in epithelioid MPM.
- Ki67 is not prognostic in non-epithelioid MPM.
- Induction chemotherapy appears to decrease MPM proliferative capacity.
