Abstract
Ki67 labeling index (LI) has been proposed as a prognostic factor in uterine leiomyosarcoma
(uLMS), although the evidence in this field is still unclear. We aimed to assess the
prognostic value of ki67 LI in uLMS. A systematic review was performed by searching
electronic databases from their inception to August 2020 for all studies assessing
the prognostic value of ki67 LI in uLMS. Ki67 LI was assessed to the nearest 10% to
define the most prognostically accurate threshold. Cox regression survival analysis
with calculation of hazard ratio (HR) of death was performed; a p-value < 0.05 was
considered significant. Ten studies were included in the qualitative review, out of
which 6 were suitable for quantitative review. The absolute risk of death was 0.29
for a ki67 LI < 10%, remained stable at 0.49 in the 10%-39% LI range and increased
to 0.65 for a LI ≥ 40%. On univariate analysis, both 10% and 40% thresholds were significantly
associated with the hazard of death, with HRs of 3.349 (p = 0.007) and 3.172 (p = 0.001),
respectively. On multivariate analysis, only the 10% threshold was significantly associated
with the hazard of death (HR = 2.712; p = 0.028). In conclusion, a Ki67 LI ≥ 10% is
a significant prognostic factor in uLMS.
Keywords
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Article info
Publication history
Published online: September 28, 2021
Accepted:
September 26,
2021
Received in revised form:
July 26,
2021
Received:
December 30,
2020
Identification
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