High tumor angiogenesis is associated with poorer survival in carcinoma of the cervix treated with radiotherapy

• Published in: Clinical cancer research Vol. 4; no. 11; pp. 2795 - 2800
• Main Authors: COOPER, R. A, WILKS, D. P, LOGUE, J. P, DAVIDSON, S. E, HUNTER, R. D, ROBERTS, S. A, WEST, C. M. L
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 01.11.1998
• Subjects: Adenocarcinoma - blood supply; Adenocarcinoma - diagnostic imaging; Adenocarcinoma - mortality; Analysis of Variance; Biological and medical sciences; Carcinoma, Squamous Cell - blood supply; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - mortality; Female; Follow-Up Studies; Humans; Medical sciences; Multivariate Analysis; Neovascularization, Pathologic; Outcome Assessment (Health Care); Prognosis; Radiation therapy and radiosensitizing agent; Radiography; Reproducibility of Results; Survival Analysis; Treatment with physical agents; Treatment. General aspects; Tumors; Uterine Cervical Neoplasms - blood supply; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - radiotherapy; Human; Carcinoma; Prognosis; Tumoral tissue; Tumoral marker; Malignant tumor; Uterine cervix; Radiotherapy; Survival; Female genital diseases; Angiogenesis; Treatment; Neovascularization; Predictive factor; Uterine cervix diseases
• ISSN: 1078-0432; 1557-3265

The purpose of this study was to examine the relationship between tumor angiogenesis and prognosis in carcinoma of the cervix treated with radiotherapy with a median follow-up time of 55 months. A retrospective study was carried out on 111 patients. Formalin-fixed, paraffin-embedded tumor biopsies were stained with anti-factor VIII using immunohistochemistry. Tumor angiogenesis was assessed by scoring the distance to the closest microvessel from random points within the tumor and the intratumor microvessel density (IMD) in the areas of highest neovascularization. High vascularity, as measured by both methods, was associated with a poor prognosis but was only significant for IMD. The 5-year survival rates for tumors with high versus low values were 50 and 65%, respectively. IMD was a significant prognostic factor within a Cox multivariate analysis. Higher tumor vascularity was associated with lower overall survival and locoregional control, but this association was not significant in the case of metastasis-free survival. The method used to assess tumor vascularity is important. The level of angiogenesis in carcinoma of the cervix is an independent prognostic parameter.