External multicentre validation of pseudomyxoma peritonei PSOGI-Ki67 classification.


Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356

Informations de publication

Date de publication:
08 2023
Historique:
received: 02 11 2022
revised: 02 03 2023
accepted: 09 03 2023
medline: 9 8 2023
pubmed: 20 3 2023
entrez: 19 3 2023
Statut: ppublish

Résumé

Pseudomyxoma peritonei (PMP) is a rare malignant disease. Adding of the Ki67 proliferation index to the PSOGI PMP classification provided two different subcategories of the extensive HG-PMP group (HG-PMP ≤15% and HG-PMP >15%) with different survival in a previous unicentric study. This study aims to carry out an external and multicentre validation of this new proposed classification. It was a prospective analysis of samples from a historical and international cohort of patients. A representative area with higher cellular density was used to determine the Ki67%. The Ki67 proliferation index (%) was determined in all the HG-PMP patients. A Cox proportional hazard models and multivariable COX models were used. The Kaplan-Meier method and the two-tailed log-rank test were used to analyse the effect of different PSOGI-Ki67 categories on OS and DFS. Its predictive accuracy was analysed using Harrel's C-index and the ROC curve. The calibration was performed using the calibration plots matching. After exclusions, 349 patients were available for analysis. The 5-years OS were 86% for LG-PMP, 59% for HG-PMP≤15, 38% for HG-PMP>15 and 42% for SRC-PMP (p = 0.0001). The 5-years DFS were 49% for LG-PMP, 35% for HG-PMP≤15, 16% for HG-PMP>15 and 18% SRC-PMP (p = 0.0001). The discrimination capability of PSOGI-Ki67 was validated. the PSOGI-Ki67 classification discriminates and predicts the OS and DFS in patients with PMP dividing the HG-PMP category into two well-defined sub-categories. The Ki67 proliferation index should be incorporated routinely in the pathology report for these patients.

Sections du résumé

BACKGROUND
Pseudomyxoma peritonei (PMP) is a rare malignant disease. Adding of the Ki67 proliferation index to the PSOGI PMP classification provided two different subcategories of the extensive HG-PMP group (HG-PMP ≤15% and HG-PMP >15%) with different survival in a previous unicentric study. This study aims to carry out an external and multicentre validation of this new proposed classification.
METHOD
It was a prospective analysis of samples from a historical and international cohort of patients. A representative area with higher cellular density was used to determine the Ki67%. The Ki67 proliferation index (%) was determined in all the HG-PMP patients. A Cox proportional hazard models and multivariable COX models were used. The Kaplan-Meier method and the two-tailed log-rank test were used to analyse the effect of different PSOGI-Ki67 categories on OS and DFS. Its predictive accuracy was analysed using Harrel's C-index and the ROC curve. The calibration was performed using the calibration plots matching.
RESULTS
After exclusions, 349 patients were available for analysis. The 5-years OS were 86% for LG-PMP, 59% for HG-PMP≤15, 38% for HG-PMP>15 and 42% for SRC-PMP (p = 0.0001). The 5-years DFS were 49% for LG-PMP, 35% for HG-PMP≤15, 16% for HG-PMP>15 and 18% SRC-PMP (p = 0.0001). The discrimination capability of PSOGI-Ki67 was validated.
CONCLUSION
the PSOGI-Ki67 classification discriminates and predicts the OS and DFS in patients with PMP dividing the HG-PMP category into two well-defined sub-categories. The Ki67 proliferation index should be incorporated routinely in the pathology report for these patients.

Identifiants

pubmed: 36935222
pii: S0748-7983(23)00377-3
doi: 10.1016/j.ejso.2023.03.206
pii:
doi:

Substances chimiques

Ki-67 Antigen 0

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1481-1488

Investigateurs

B Rufián-Andújar (B)
F Valenzuela-Molina (F)
A Casado-Adam (A)
J M Sánchez-Hidalgo (JM)
S Rufián-Peña (S)
R Ortega-Salas (R)
M Granados-Rodríguez (M)
M C Vázquez-Borrego (MC)
F I Bura (FI)
J P Castaño (JP)
S Kusamura (S)
D Baratti (D)
M Guaglio (M)
Pascual A Angel Castaño (PA)
Ruiz de Valbuena Bueno C (R)
F Quénet (F)
S Yilmaz (S)
Torun B Canbay (TB)
E Sola Vendrell (E)
L González-Bayón (L)
W Ceelen (W)
W Willaert (W)
J Demuytere (J)
M E Alberto-Vilchez (ME)
S Gül-Klein (S)
Glehen Olivier (G)
Isabelle Bonnefoy (I)
Cecile Odin (C)
Laurent Villeneuve (L)
Sylvie Isaac (S)
Nazim Benzerdjeb (N)
Juliette Fontaine (J)
Philippe Bertheau (P)
Maysoun Kassem (M)
Isabelle Sourrouille (I)
Maximiliano Gelli (M)
Charles Honore (C)
Peggy Dartigues (P)
Valérie Boige (V)
Véroniques Verriele (V)
Cécile Brignad (C)
Gerlinde Averous (G)
C Shields (C)
J Aird (J)
Antonio Scapinello (A)
Maria Chiara Biatta (MC)
Marco Tonello (M)
Chiara Cenzi (C)

Informations de copyright

Copyright © 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Auteurs

A Arjona-Sanchez (A)

Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. Electronic address: https://twitter.com/alarjosan.

A Martinez-López (A)

Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Spain; Pathology Unit, Reina Sofia University Hospital, Spain.

M T Moreno-Montilla (MT)

Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.

J Mulsow (J)

National Centre for Peritoneal Malignancy, Mater Hospital, Dublin, Ireland.

P Lozano-Lominchar (P)

Department of General Surgery, Peritoneal Carcinomatosis, Sarcoma and Complex Pelvis Cases, Hospital General Universitario Gregorio Marañon, Madrid, Spain.

B Martínez-Torres (B)

Department of General Surgery, Hospital University Fuenlabrada, Madrid, Spain.

B Rau (B)

Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität, Department of Special Surgical Oncology, Berlin, Germany.

E Canbay (E)

NPO HIPEC Istanbul centre for Peritoneal Surface Malignancies, Istambul, Turkey.

A Sommariva (A)

Advanced Surgical Oncology Unit Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology IOV-IRCCS Padova, Italy.

M Milione (M)

Pathology Division, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

M Deraco (M)

Peritoneal Surfaces Malignance Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

O Sgarbura (O)

Department of Surgical Oncology, Cancer Institute of Montpellier, University of Montpellier, IRCM, Institut de Recherche en Cancérologie de Montpellier, Université de Montpellier, Institut régional du Cancer de Montpellier, Montpellier, France.

A Torgunrud (A)

Department of Tumor Biology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.

V Kepenekian (V)

Unit of Surgery, Hospitaux du Lyon, France.

N J Carr (NJ)

Pathology Department, Peritoneal Malignancy Institute Basingstoke, UK.

A Hoorens (A)

Department of Pathology, Ghent University Hospital, Ghent, Belgium.

J B Delhorme (JB)

Department of general and digestive surgery, Hautepierre Hospital, Hôpitaux universitaires de Strasbourg, France.

R Wernert (R)

Surgical Oncology, ICO Paul Papin, Angers, France.

D Goere (D)

Digestive Surgery, APHP Hopital Saint Louis, France.

L Martin-Roman (L)

National Centre for Peritoneal Malignancy, Mater Hospital, Dublin, Ireland.

S Cosyns (S)

Department of Human Structure and Repair, Ghent University, Ghent, Belgium.

K Flatmark (K)

Department of Gastorenterological Surgery, The Norwegian Radium Hospital, Oslo university Hospital, Oslo, Norway.

B Davidson (B)

Department of Pathology, The Norwegian Radium Hospital, Oslo university Hospital, Oslo Norway. University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, N-0316, Oslo, Norway.

L Khellaf (L)

Department of Pathology, Cancer Institute of Montpellier, University of Montpellier, Montpellier, France.

F Pereira-Perez (F)

Department of General Surgery, Hospital University Fuenlabrada, Madrid, Spain.

L Rodriguez-Ortiz (L)

Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Digestive Surgery, APHP Hopital Saint Louis, France.

A Ibáñez-Costa (A)

Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.

A Romero-Ruiz (A)

Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. Electronic address: b72rorua@uco.es.

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