PMID- 31996397 OWN - NLM STAT- MEDLINE DCOM- 20201215 LR - 20201215 IS - 1525-1438 (Electronic) IS - 1048-891X (Linking) VI - 30 IP - 4 DP - 2020 Apr TI - Ki67 expression as a predictor of chemotherapy outcome in low-grade serous ovarian cancer. PG - 498-503 LID - 10.1136/ijgc-2019-000976 [doi] AB - OBJECTIVE: Low-grade serous ovarian cancers characterize a unique clinical pattern and lower chemotherapy responsiveness. The expression level of Ki67 is associated with differences in prognosis; however, this has not yet been evaluated in regard to predicting the outcome of therapy. METHODS: Patients with low-grade serous ovarian cancers were identified in an institutional database. Receiver-operator characteristics (ROC) curve analysis was performed to find cut-off values of Ki67 to discriminate patients with residual tumor mass after surgery from maximal debulked patients: therapy response and therapy-free interval (TFI). RESULTS: A total of 68 patients with low-grade serous ovarian cancer were identified. All patients underwent surgery. 61 (89.7%) patients received platinum-based first-line chemotherapy; of these 61 patients, 13 (21.3%) had residual mass (>0 mm) after primary cytoreduction and 11 (18%) received neo-adjuvant chemotherapy. Ki67 >/=3.6% was associated with higher risk of residual mass after surgery (OR 8.1, 95% CI 1.45 to 45.18; p=0.017). Patients with Ki67 <3.6% showed a therapy-free interval of >/=6 months more often (OR 13.9, 95% CI 1.62 to 118.40; p=0.016). In the multivariate analysis of TFI <6 months, including CA125, age at diagnosis, peritoneal carcinomatosis, and ascites, Ki67 <3.6% remained a significant prognostic factor (OR 18.8, 95% CI 1.77 to 199.09; p=0.015). Chemotherapy responsiveness was evaluated in 21 patients who had residual disease and/or received neo-adjuvant chemotherapy. Ki67 >/=4.0% (OR 44.1, 95%CI 2.36-825.17, p = 0.011) was related to a significantly higher response rate (complete and partial response). CONCLUSIONS: This is the first study to show an association between Ki67 expression and chemotherapy response, duration of TFI to platinum-based chemotherapy as well as outcome of surgery in low-grade serous ovarian cancers. Further prospective trials should use Ki-67 as a stratification factor to explore the effect of chemotherapy and endocrine strategies. CI - (c) IGCS and ESGO 2020. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Grabowski, Jacek P AU - Grabowski JP AD - Department of Gynecology with Center of Oncological Surgery, Virchow Campus Clinic, Charite Universitatsmedizin Berlin, Berlin, Germany jacek.grabowski@charite.de. FAU - Martinez Vila, Clara AU - Martinez Vila C AD - Department of Medical Oncology, Hospital Clinic de Barcelona, Barcelona, Spain. FAU - Richter, Rolf AU - Richter R AD - Department of Gynecology with Center of Oncological Surgery, Virchow Campus Clinic, Charite Universitatsmedizin Berlin, Berlin, Germany. FAU - Taube, Eliane AU - Taube E AD - Institute of Pathology, Charite Universitatsmedizin Berlin, Berlin, Germany. FAU - Plett, Helmut AU - Plett H AD - Department of Gynecology with Center of Oncological Surgery, Virchow Campus Clinic, Charite Universitatsmedizin Berlin, Berlin, Germany. AD - Department of Gynecology and Gynecologic Oncology, Kliniken-Essen-Mitte, Essen, Germany. FAU - Braicu, Elena AU - Braicu E AD - Department of Gynecology with Center of Oncological Surgery, Virchow Campus Clinic, Charite Universitatsmedizin Berlin, Berlin, Germany. FAU - Sehouli, Jalid AU - Sehouli J AD - Department of Gynecology with Center of Oncological Surgery, Virchow Campus Clinic, Charite Universitatsmedizin Berlin, Berlin, Germany. LA - eng PT - Journal Article DEP - 20200128 PL - England TA - Int J Gynecol Cancer JT - International journal of gynecological cancer : official journal of the International Gynecological Cancer Society JID - 9111626 RN - 0 (Ki-67 Antigen) RN - 0 (MKI67 protein, human) RN - 0 (Organoplatinum Compounds) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Combined Chemotherapy Protocols/therapeutic use MH - Cystadenocarcinoma, Serous/*drug therapy/*metabolism/pathology/surgery MH - Female MH - Humans MH - Immunohistochemistry MH - Ki-67 Antigen/*biosynthesis MH - Middle Aged MH - Neoplasm Grading MH - Organoplatinum Compounds/administration & dosage MH - Ovarian Neoplasms/*drug therapy/*metabolism/pathology/surgery MH - Young Adult OTO - NOTNLM OT - ovary COIS- Competing interests: None declared. EDAT- 2020/01/31 06:00 MHDA- 2020/12/16 06:00 CRDT- 2020/01/31 06:00 PHST- 2019/10/01 00:00 [received] PHST- 2019/12/23 00:00 [revised] PHST- 2019/12/31 00:00 [accepted] PHST- 2020/01/31 06:00 [pubmed] PHST- 2020/12/16 06:00 [medline] PHST- 2020/01/31 06:00 [entrez] AID - ijgc-2019-000976 [pii] AID - 10.1136/ijgc-2019-000976 [doi] PST - ppublish SO - Int J Gynecol Cancer. 2020 Apr;30(4):498-503. doi: 10.1136/ijgc-2019-000976. Epub 2020 Jan 28.