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Ki-67 index as a predictor of vestibular schwannoma regrowth or recurrence

Published online by Cambridge University Press:  15 April 2019

J Prueter ,
D Norvell  and
D Backous
J Prueter*
Affiliation:
Department of Hearing and Skull Base Surgery, Swedish Hospital, Swedish Neuroscience Institute, Washington, USA
D Norvell
Affiliation:
Spectrum Research, Steilacoom, Washington, USA
D Backous
Affiliation:
Puget Sound ENT, Proliance Surgeons, Edmonds, Washington, USA
*
Author for correspondence: Dr James Prueter, Swedish Neuroscience Institute, 21911 76th Avenue W, Suite 211, Edmonds, WA 98026, USA E-mail: jamescprueter@gmail.com Fax: +1 425 670 6718
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Abstract

Background

Ki-67 is a monoclonal antibody that provides a means of evaluating the growth fraction of normal and neoplastic human cell populations. A Ki-67 index of less than 3 per cent is expected for a typical schwannoma. Vestibular schwannomas with an index of greater than 3 per cent are presumed to be actively proliferating and pose a theoretically higher risk for regrowth or recurrence.

Methods

A retrospective chart review was conducted. Ki-67 staining was performed and specimens were divided into two groups according to Ki-67 activity: less than 3 per cent (low index), and 3 per cent or greater (elevated index).

Results

Eight patients (53.3 per cent) with elevated Ki-67 had recurrence or regrowth, versus five (8.5 per cent) in the low Ki-67 group. Among the 13 patients with recurrence or regrowth, the average Ki-67 value was 4.3 per cent. Among the 61 patients without recurrence or regrowth, the average Ki-67 value was 1.0 per cent.

Conclusion

The Ki-67 labelling index reliably identifies vestibular schwannomas with an elevated potential for recurrence or regrowth in subtotal or total resection cases. In patients with a Ki-67 index greater than 3 per cent, more frequent clinical examination and radiological follow up are recommended.

Keywords

Schwannoma, VestibularRecurrenceNeuroma, Acoustic
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 3 , March 2019 , pp. 205 - 207
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr J Prueter takes responsibility for the integrity of the content of the paper

Presented as a poster at the Combined Otolaryngology Spring Meeting, 18–22 April 2018, National Harbor, Maryland, USA.

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