The prognostic value of Ki-67 in nasopharyngeal carcinoma (NPC) was controversial according to previous studies. We aimed to clarify the association between K-67 expression and survival in NPC through meta-analysis. We conducted a meta-analysis to explore the potential prognostic effect of Ki-67 on overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS) in NPC. A total of 13 studies comprising 1314 NPC patients were included. High Ki-67 expression was associated with poor OS (hazard ratio [HR]=2.70, 95% confidence interval [CI]=1.97–3.71, p<0.001), DFS (HR=1.93, 95% CI=1.49–2.50, p<0.001), and LRFS (HR=1.86, 95% CI=1.11–3.12, p=0.019). However, there was no significant association between Ki-67 and DMFS (HR=1.37, 95% CI=0.78–2.38, p=0.270). Furthermore, the prognostic role of Ki-67 was maintained throughout different sample sizes, analyses of HR, and study designs for OS and DFS in various subgroups. Elevated Ki-67 expression is a reliable prognostic factor for poorer survival outcomes in NPC.

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