Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 30:12:895672.
doi: 10.3389/fonc.2022.895672. eCollection 2022.

Proliferation Marker Ki67 as a Stratification Index of Adjuvant Chemotherapy for Resectable Mucosal Melanoma

Lirui Tang  1 , Xiaoting Wei  1 , Caili Li  1 , Jie Dai  1 , Xue Bai  1 , Lili Mao  1 , Zhihong Chi  1 , Chuanliang Cui  1 , Bin Lian  1 , Bixia Tang  1 , Yu Du  1 , Xuan Wang  1 , Yumei Lai  2 , Xinan Sheng  3 , Xieqiao Yan  3 , Siming Li  3 , Li Zhou  3 , Yan Kong  1 , Zhongwu Li  2 , Lu Si  1 , Jun Guo  1   3
Affiliations

Proliferation Marker Ki67 as a Stratification Index of Adjuvant Chemotherapy for Resectable Mucosal Melanoma

Lirui Tang et al. Front Oncol. .

Abstract

Background: Adjuvant chemotherapy has been shown to produce a favorable prognosis for patients with resectable mucosal melanoma (MM), resulting in the need for stratification to optimally select patients to benefit from adjuvant therapy. This study analyzed Ki67 as a potential stratification index for adjuvant chemotherapy in resectable MM.

Methods: Patients with resected MM who received subsequent adjuvant therapy in Beijing Cancer Hospital between 2010 and 2018 were retrospectively enrolled and analyzed. Relapse-free survival (RFS) and melanoma-specific survival (MSS) curves were used to perform the survival comparisons across different subgroups.

Results: From Jan 2010 to Dec 2018, 1106 MM patients were screened from a database of 4706 patients and 175 of these patients were finally enrolled. A total of 100 patients received temozolomide (TMZ)-based adjuvant chemotherapy and 75 patients received high-dose interferon-α2b (HDI) adjuvant therapy. Compared with HDI, patients who received TMZ-based adjuvant chemotherapy had significantly superior RFS (21.0 vs. 9.6 months, P = 0.002). For patients with low Ki67 expression (<30%), the two regimens showed no significant difference for impact on RFS (33.9 vs. 22.7 months, P = 0.329). However, for patients with high Ki67 expression (≥30%), TMZ-based adjuvant chemotherapy achieved favorable RFS compared with HDI (18.0 vs. 6.7 months, P < 0.001) and tended to improve MSS compared to HDI (41.4 vs. 25.1 months, P = 0.067).

Conclusion: Compared with HDI, adjuvant chemotherapy may be more relevant for patients with Ki67 ≥ 30%. Ki67 may serve as a potential index to distinguish populations benefiting from adjuvant chemotherapy in resectable MM, and may provide a basis for stratification in the selection of adjuvant regimens.

Keywords: HDI; Ki67; adjuvant chemotherapy; melanoma-specific survival; mucosal melanoma (MM); relapse-free survival (RFS); stratification index.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of inclusion and exclusion criteria for this study. A total of 1106 MM patients were screened from a database of 4406 patients, and 175 patients were finally enrolled.
Figure 2
Figure 2
Kaplan-Meier curves of RFS (A) and MSS (B) according to patients receiving different adjuvant regimens. RFS, relapse-free survival; MSS, melanoma-specific survival; TMZ, temozolomide; HDI, high-dose interferon-a2b.
Figure 3
Figure 3
Kaplan-Meier curves of RFS (A) and MSS (B) according to patients at different Ki67 levels. RFS, relapse-free survival; MSS, melanoma-specific survival.
Figure 4
Figure 4
Kaplan-Meier curves of RFS (A) and MSS (B) according to adjuvant regimens in patients in the Ki67 low (<30%) and Ki67 high (>=30%) group. RFS, relapse-free survival; MSS, melanoma-specific survival; TMZ, temozolomide; HDI, high-dose interferon-a2b.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Pandey M, Mathew A, Abraham EK, Ahamed IM, Nair KM. Primary Malignant Melanoma of the Mucous Membranes. Eur J Surg Oncol (1998) 24(4):303–7. doi: 10.1016/s0748-7983(98)80011-5 - DOI - PubMed
    1. Olla D, Neumeister MW. Mucosal Melanoma. Clin Plast Surg (2021) 48(4):707–11. doi: 10.1016/j.cps.2021.05.010 - DOI - PubMed
    1. López F, Rodrigo JP, Cardesa A, Triantafyllou A, Devaney KO, Mendenhall WM, et al. . Update on Primary Head and Neck Mucosal Melanoma. Head Neck (2016) 38(1):147–55. doi: 10.1002/hed.23872 - DOI - PMC - PubMed
    1. Mao L, Qi Z, Zhang L, Guo J, Si L. Immunotherapy in Acral and Mucosal Melanoma: Current Status and Future Directions. Front Immunol (2021) 12:680407. doi: 10.3389/fimmu.2021.680407 - DOI - PMC - PubMed
    1. Quek C, Rawson RV, Ferguson PM, Shang P, Silva I, Saw RPM, et al. . Recurrent Hotspot Sf3b1 Mutations at Codon 625 in Vulvovaginal Mucosal Melanoma Identified in a Study of 27 Australian Mucosal Melanomas. Oncotarget (2019) 10(9):930–41. doi: 10.18632/oncotarget.26584 - DOI - PMC - PubMed