In Reply to Wilkins et al

To the Editor: Thank you to Dr. Wilkins and colleagues for the clarifications provided in your response (1) to my recent editorial (2) on your article (3). I am sure the readership appreciates your valuable added insights, but I still unfortunately believe my original comments regarding the limitations of Ki-67 as a prognostic biomarker hold true. I fully understand that you analyzed Ki-67 as a continuous variable and the interpretation of the hazard ratio estimate. Although assessing Ki-67 as a continuous variable maximizes statistical power, it also has notable downsides, especially with a biomarker like Ki-67.

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