Prognostic factors for keratocystic odontogenic tumor (odontogenic keratocyst): analysis of clinico-pathologic and immunohistochemical findings in cysts treated by enucleation

• Published in: Journal of oral pathology & medicine 2009-04, Vol.38 (4), p.386-392
• Main Authors: Kuroyanagi, Norio, Sakuma, Hidenori, Miyabe, Satoru, Machida, Junichiro, Kaetsu, Atsuo, Yokoi, Motoo, Maeda, Hatsuhiko, Warnakulasuriya, Saman, Nagao, Toru, Shimozato, Kazuo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Dentistry; Female; Humans; Immunohistochemistry; Keratins; keratocystic odontogenic tumor; Ki-67; Ki-67 Antigen - biosynthesis; Male; Medical sciences; Middle Aged; Odontogenic Cysts - chemistry; Odontogenic Cysts - metabolism; Odontogenic Cysts - pathology; Odontogenic Cysts - surgery; odontogenic keratocyst; Otorhinolaryngology. Stomatology; p53; Prognosis; prognostic markers; Recurrence; Tumor Suppressor Protein p53 - biosynthesis; Young Adult
• ISSN: 0904-2512; 1600-0714
• DOI: 10.1111/j.1600-0714.2008.00729.x

Background:  The purpose of this study was to determine prognostic factors for the recurrence of keratocystic odontogenic tumors (KCOTs) following simple enucleation by examining clinico‐pathologic and immunohistochemical findings. Methods:  Following enucleation, the frequency of recurrence among 32 subjects diagnosed with KCOT was analyzed for tumor site, radiographic and histologic features, and immunopositivity for Ki‐67 and p53. Results:  Keratocystic odontogenic tumors in four out of 32 subjects (12.5%) recurred during the follow‐up period (median: 33 months, range: 7–114 months). Three out of four subjects (75.0%) among recurrent group showed high expression of Ki‐67 (LI >10%) in basal layer and four (4/28; 14.3%) among non‐recurrence group (P = 0.025). Expression of p53 among non‐recurrent group was observed in 11 subjects (11/28; 39.3%), and in three subjects (3/4; 75.0%) among the recurrent group (P = 0.295). Hazard risk for the recurrence of KCOT was 4.02 (95% CI 1.42–18.14) for high Ki‐67 expression in the basal layer by the Cox proportional hazard model (P = 0.009). In our study, none of the other clinico‐pathologic variables were associated with the recurrence of KCOT. Conclusion:  The results suggested that the evaluation of Ki‐67 expression in KCOT at the time of pathological diagnosis might be helpful for consideration of appropriate adjunctive surgical procedures to avoid a recurrence and may serve as a prognostic marker.