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Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis

  • Authors:
    • Fahd Refai
  • View Affiliations / Copyright

    Affiliations: Department of Pathology, Faculty of Medicine, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah 25668, Saudi Arabia
    Copyright: © Refai et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 457
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    Published online on: October 15, 2024
       https://doi.org/10.3892/etm.2024.12747
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Abstract

Numerous clinicopathological features have been examined as predictive factors for adverse outcomes in patients with phyllodes tumor (PT) of the breast, but there are still no definitive predictive markers to guide management, despite the persistent risk of recurrence, even in benign disease. Whether Ki67 has prognostic value in PT remains uncertain. Therefore, a systematic review and meta‑analysis were performed to examine whether Ki67 is associated with adverse clinical outcomes, particularly recurrence, in patients with PT. The PubMed/MEDLINE, Web of Science, Scopus, Embase and Cochrane Library databases were searched from inception to July 2024. Study characteristics and outcomes (recurrence and overall survival) according to Ki67 status were extracted from each eligible study, and pooled log odds ratios (OR) with 95% CI were derived using a random‑effects model. A total of five studies comprising 280 cases were eligible for inclusion. The adverse outcome rate for the Ki67high (Ki67 >10 or >11.2%) population was 28.7% (95% CI, 20.1‑38.6%), while the adverse outcome rate for the Ki67low population was 9.4% (95% CI, 5.4‑13.5%). Ki67high was associated with an increased odds of an adverse outcome [log OR, 1.26 (95% CI, 0.38‑2.15; P=0.005)] compared with a Ki67low status. All five studies scored 8 points on the Newcastle‑Ottawa Scale, equivalent to ‘good’ quality according to Agency for Healthcare Research and Quality standards, and no significant publication bias was noted. This was the first meta‑analysis of the predictive value of Ki67 in PT of the breast. A relatively high Ki67 index (>10%) is associated with recurrence. It is timely to re‑evaluate the prognostic value of Ki67 in large retrospective cohorts with long follow‑up to firmly establish whether it could contribute to identifying patients at risk of recurrence, particularly those with histologically benign disease. Doing so could impact clinical practice by refining follow‑up recommendations based on quality evidence.
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Copy and paste a formatted citation
Spandidos Publications style
Refai F: Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis. Exp Ther Med 28: 457, 2024.
APA
Refai, F. (2024). Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 28, 457. https://doi.org/10.3892/etm.2024.12747
MLA
Refai, F."Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 28.6 (2024): 457.
Chicago
Refai, F."Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 28, no. 6 (2024): 457. https://doi.org/10.3892/etm.2024.12747
Copy and paste a formatted citation
x
Spandidos Publications style
Refai F: Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis. Exp Ther Med 28: 457, 2024.
APA
Refai, F. (2024). Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 28, 457. https://doi.org/10.3892/etm.2024.12747
MLA
Refai, F."Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 28.6 (2024): 457.
Chicago
Refai, F."Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 28, no. 6 (2024): 457. https://doi.org/10.3892/etm.2024.12747
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