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Prognostic Value of Ki-67 Labeling Index and Postoperative Radiotherapy in WHO Grade II Meningioma

Choi, Yunseon MD*,†; Lim, Do Hoon MD, PhD*; Yu, Jeong Il MD*; Jo, Kyungil MD; Nam, Do-Hyun MD, PhD; Seol, Ho Jun MD, PhD; Lee, Jung-Il MD, PhD; Kong, Doo-Sik MD, PhD; Suh, Yeon-Lim MD, PhD§; Nam, Heerim MD, PhD

American Journal of Clinical Oncology: January 2018 - Volume 41 - Issue 1 - p 18–23
doi: 10.1097/COC.0000000000000224
Original Articles: Central Nervous System

Objective: This study was performed to determine the clinical significance of the Ki-67 labeling index (LI) for local control (LC) in patients with World Health Organization (WHO) grade II meningioma. We also tried to discern the effect of postoperative radiotherapy (PORT) on LC depending upon the Ki-67 LI value.

Materials and Methods: The medical records and values of Ki-67 LIs were retrospectively reviewed for 50 patients who underwent surgical resection of intracranial WHO grade II meningiomas at Samsung Medical Center from May 2001 to December 2012. Forty-three patients (86%) were treated with immediate PORT. The median total radiation dose was 60 Gy (range, 54 to 60 Gy).

Results: The median follow-up was 47.4 months. The mean Ki-67 LI was 13% (range, 1% to 47%). Twelve patients (24.0%) showed local failure, and 8 patients (16.0%) experienced local failure even after PORT. The mean Ki-67 LI was 15% in patients with local failure (n=12) and 12% in patients without local failure (n=38). The 3-year actuarial LC was 80.5%. The 3-year overall survival was 89.5%. Ki-67 LI>13% and PORT were significant prognostic factors for LC (P=0.015 and 0.009, respectively). In patients with Ki-67 LI>13% (n=17), PORT (n=14) improved LC (P<0.001). However, PORT (n=29) did not affect LC (P=0.412) for patients with Ki-67 LI≤13% (n=33).

Conclusions: Ki-67 LI can be a useful prognostic factor for LC in WHO grade II meningioma. In patients with Ki-67 LI>13%, PORT should be recommended to improve LC.

Departments of *Radiation Oncology

Neurosurgery

§Pathology, Samsung Medical Center

Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul

Department of Radiation Oncology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea

The authors declare no conflicts of interest.

Reprints: Do Hoon Lim, MD, PhD, Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. E-mail: dh8lim@skku.edu.

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