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August 17, 2025Open Access

Association between Ki-67 and clinical outcomes in 324 Chinese patients with resectable acral melanoma

YTYi TengDalian University of Technology JWJin WuNanning Normal University WZWeizhen ZhangChengde Medical University

Key Points

High ki-67 expression is associated with shorter disease-free survival and overall survival, indicating a poor prognosis.
Patients with high ki-67 expression showed a significantly higher tumor thickness greater than 4 mm, with 45.5% compared to 24.3%.
Multivariate analysis confirmed ki-67, age, stage, and ldh as independent predictors of overall survival.
These findings highlight the importance of ki-67 as a potential prognostic biomarker for patient outcomes in acral melanoma.

Abstract

The relationship between Ki-67 expression and clinical prognosis in patients with resectable acral melanoma (AM) remains unclear. This study explores the prognostic role of Ki-67 in AM using data from 324 patients across five Chinese centers. Patients were divided into low Ki-67 expression and high Ki-67 expression groups based on pathological reports. The log-rank test was used to compare disease-free survival (DFS) and overall survival (OS), and the Cox proportional hazards regression model was employed to identify prognostic factors. Among the 324 patients included in the study, 181 (55.8%) were in the low Ki-67 expression group, and 143 (44.2%) were in the high Ki-67 expression group. The high Ki-67 expression group exhibited a higher incidence of tumor thickness > 4 mm (45.5% vs 24.3%, P < 0.001), ulceration (65.7% vs 54.1%, P = 0.035), stage III (31.5% vs 16.0%, P < 0.001), LDH ≥ 250 U/L (14.0% vs. 6.6%, P = 0.028), and positive sentinel lymph nodes (28.0% vs 11.1%, P = 0.029). High Ki-67 predicted shorter DFS (26.8 vs 74.1 months, P = 0.025) and OS (52.1 months vs NR, P < 0.001). Multivariate analysis identified Ki-67, age, stage and LDH as independent OS predictors.

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