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J Neurol Surg B Skull Base 2023; 84(02): 119-128
DOI: 10.1055/a-1760-2126
Original Article

Predictive Value of Ki-67 Index in Evaluating Sporadic Vestibular Schwannoma Recurrence: Systematic Review and Meta-analysis

Kunal Vakharia
1   Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, United States
2   Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
Hirotaka Hasegawa
1   Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, United States
3   Department of Neurosurgery, Tokyo University, Tokyo, Japan
,
Christopher Graffeo
1   Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, United States
4   Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States
,
Mohammad H. A. Noureldine
2   Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
Salomon Cohen-Cohen 
1   Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Avital Perry
5   Department of Neurosurgery, Sheba Medical Center, Tel Aviv, Israel
,
Matthew L. Carlson
1   Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, United States
6   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Colin L. W. Driscoll
1   Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, United States
6   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Maria Peris-Celda
1   Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Jamie J. Van Gompel 
1   Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Michael J. Link
1   Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, United States
6   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
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Abstract

Introduction Ki-67 is often used as a proliferation index to evaluate how aggressive a tumor is and its likelihood of recurrence. Vestibular schwannomas (VS) are a unique benign pathology that lends itself well to evaluation with Ki-67 as a potential marker for disease recurrence or progression following surgical resection.

Methods All English language studies of VSs and Ki-67 indices were screened. Studies were considered eligible for inclusion if they reported series of VSs undergoing primary resection without prior irradiation, with outcomes including both recurrence/progression and Ki-67 for individual patients. For published studies reporting pooled Ki-67 index data without detailed by-patient values, we contacted the authors to request data sharing for the current meta-analysis. Studies reporting a relationship between Ki-67 index and clinical outcomes in VS for which detailed patients' outcomes or Ki-67 indices could not be obtained were incorporated into the descriptive analysis, but excluded from the formal (i.e., quantitative) meta-analysis.

Results A systematic review identified 104 candidate citations of which 12 met inclusion criteria. Six of these studies had accessible patient-specific data. Individual patient data were collected from these studies for calculation of discrete study effect sizes, pooling via random-effects modeling with restricted maximum likelihood, and meta-analysis. The standardized mean difference in Ki-67 indices between those with and without recurrence was calculated as 0.79% (95% confidence interval [CI]: 0.28–1.30; p = 0.0026).

Conclusion Ki-67 index may be higher in VSs that demonstrate recurrence/progression following surgical resection. This may represent a promising means of evaluating tumor recurrence and potential need for early adjuvant therapy for VSs.

Keywords

histopathology - vestibular schwannoma - acoustic neuroma - recurrence - progression - Ki-67 - index - systematic review - meta-analysis


Publication History

Received: 23 June 2021

Accepted: 31 January 2022

Accepted Manuscript online:
03 February 2022

Article published online:
03 March 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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