title: High tumor angiogenesis is associated with poorer survival in carcinoma of the cervix treated with radiotherapy.
abstract: 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.
authors.affiliation: Cancer Research Campaign Section of Genome Damage and Repair, Paterson Institute for Cancer Research, Manchester, United Kingdom.
authors.forename: R A
authors.initials: RA
authors.lastname: Cooper
authors.forename: D P
authors.initials: DP
authors.lastname: Wilks
authors.forename: J P
authors.initials: JP
authors.lastname: Logue
authors.forename: S E
authors.initials: SE
authors.lastname: Davidson
authors.forename: R D
authors.initials: RD
authors.lastname: Hunter
authors.forename: S A
authors.initials: SA
authors.lastname: Roberts
authors.forename: C M
authors.initials: CM
authors.lastname: West
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000401:mortality; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015999:Multivariate Analysis; D009389:Neovascularization, Pathologic; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011859:Radiography; D015203:Reproducibility of Results; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000098:blood supply / Q000401:mortality / Q000532:radiotherapy*