Prognostic value of Ki-67 expression in conversion therapy for colorectal liver-limited XXXX .

@entity1 @entity901 @entity2600 @entity5 @entity3
INTRODUCTION: The objective of this study was to examine the prognostic value of Ki-67 expression in conversion therapy for colorectal liver-confined @entity3 . METHODS: We enrolled a total of 96 @entity1 including 54 @entity1 who received @entity901 - or @entity2600 -based chemotherapy and curative hepatectomy for initially unresectable @entity3 (conversion group) and 42 @entity1 with initially resectable liver @entity3 (straight hepatectomy group). Ki-67 expression was examined in 96 resected specimens but excluded the 2 specimens that revealed no @entity5 cells in conversion group. RESULTS: Conversion therapy leads to greater survival that is equivalent to that straight hepatectomy group. In conversion group, high Ki-67 expression (> 30%) levels were detectable in 33 @entity1 (64%) after chemotherapy prior to conversion therapy. High Ki-67 expression was significantly associated with shorter disease-free survival and worse overall survival (P < 0.01 in both), and was an independent worse prognostic factor of disease-free survival and overall survival (hazard ratio [HR] and P-values were 5.608, 0.001 and 5.366, 0.04, respectively) in @entity1 with conversion therapy. Interestingly, even in the @entity1 with RECIST PR (n = 32), high Ki-67 expression was significantly shorter disease-free survival compared to low Ki-67 expression (P < 0.001). In contrast to conversion group, there was no significant difference in disease free survival and overall survival between low (n = 14, 33%) and high (n = 28, 67%) Ki-67 expressions in @entity1 with straight hepatectomy (P = 0.14 and 0.74, respectively). CONCLUSIONS: Residual Ki-67 expression is a useful biomarker for worse prognostic outcomes after conversion therapy. High Ki-67 expression may be a biomarker of micrometastases containing aggressive @entity5 cells.
