Journal
BRITISH JOURNAL OF CANCER
Volume 100, Issue 6, Pages 888-893Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/sj.bjc.6604951
Keywords
prostate cancer; Ki-67; watchful waiting; active surveillance; biomarker
Categories
Funding
- Cancer Research UK
- National Institute of Health (SPORE)
- Koch Foundation
- NCRI
- Grand Charity of Freemasons
- Orchid Appeal
- MRC [G0501019] Funding Source: UKRI
- Medical Research Council [G0501019] Funding Source: researchfish
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Treatment decisions after diagnosis of clinically localised prostate cancer are difficult due to variability in tumour behaviour. We therefore examined one of the most promising biomarkers in prostate cancer, Ki-67, in a cohort of 808 patients diagnosed with prostate cancer between 1990 and 1996 and treated conservatively. Ki-67 expression was assessed immunohistochemically, in two laboratories, by two different scoring methods and the results compared with cancer-specific and overall survival. The power of the biomarker was compared with Gleason score and initial serum prostate-specific antigen (PSA). Both methods showed that Ki-67 provided additional prognostic information beyond that available from Gleason score and PSA: for the semi-quantitative method, Delta chi(2) (1 d.f.) = 24.6 (P<0.0001), overall survival chi(2) = 20.5 (P<0.0001), and for the quantitative method, Delta chi(2) (1 d.f.) = 15.1 (P < 0.0001), overall survival chi(2) = 10.85 (P = 0.001). Ki-67 is a powerful biomarker in localised prostate cancer and adds to a model predicting the need for radical or conservative therapy. As it is already in widespread use in routine pathology, it is confirmed as the most promising biomarker to be applied into routine practice.
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