Abstract
Uncontrolled proliferative activity is one of the determinants of malignant growth and known to be a prognostic factor in a variety of human tumors. Many works have been published on this topic in pulmonary neoplasms but most studies are underpowered or have no clinical data available.
To ultimately clarify the role of proliferation in non-small cell lung cancer (NSCLC) we investigated the proliferative activity of >1000 NSCLC by Ki-67 staining and correlated the data with clinicopathological characteristics including therapy response and survival.
The mean proliferative fraction in NSCLC was 40.7%. Adenocarcinomas (ADC) proliferated significantly less than all other types of NSCLC but proliferation was tightly linked to specific growth patterns. Overall, proliferative activity was not associated with overall, disease free and disease specific survival. However, when patients were stratified according to adjuvant therapy, those patients with high intratumoral proliferative activity and without adjuvant chemotherapy or radiation had significantly diminished survival times when compared to patients whose tumors were proliferating slowly. These associations were reverted in the group of patients who received radio-/chemotherapy.
Our study comprehensively clarifies the impact of proliferative activity on outcome in NSCLC patients. Our data suggest that Ki-67 stains can be used as an adjunct in the selection of patients for adjuvant therapy.
- © 2012 ERS
