title: Intratumoral microvessel density, response to chemotherapy and clinical outcome of patients with advanced ovarian carcinoma.
abstract: BACKGROUND
  The aim of this study was to assess intratumoral microvessel density (IMD) in tissue samples from primary ovarian carcinomas, and to correlate this angiogenic parameter with the common clinico-pathological variables, response to chemotherapy and prognosis of patients with this malignancy.
  
  
  METHODS
  The investigation was conducted on 64 patients who underwent initial surgery for FIGO stages I-IV ovarian carcinoma. Paraffin-embedded sections of primary tumor specimens were analyzed for IMD by immunohistochemistry using anti-CD34 antibodies. In detail, we assessed the 49 patients with advanced (FIGO stages II-IV) disease. Postoperative chemotherapy consisted of paclitaxel/platinum-based chemotherapy in 36 (73.5%) patients and platinum-based chemotherapy in 13.
  
  
  RESULTS
  The IMD ranged from 6 to 115 microvessels/field, with a median value of 40, and correlated with none of the common clinico-pathological variables of ovarian carcinoma. As for the patients with advanced disease, women with elevated IMD (> or = 40 microvessels/field) had a higher chance of achieving a complete response to chemotherapy when compared to those with lower IMD (p = 0.0068). Multiple logistic regression showed that IMD was an independent predictor of complete response to chemotherapy (p = 0.0094). By log-rank test, patients with elevated IMD had a better progression-free survival (p = 0.0039) and a better overall survival (p = 0.0365) when compared to those with lower IMD. The Cox model showed that IMD was the only independent prognostic variable for both progression-free survival (p = 0.0112) and overall survival (p = 0.0296).
  
  
  CONCLUSIONS
  The present retrospective analysis seems to show a positive association between IMD, response to chemotherapy, mainly represented by a paclitaxel/platinum-based regimen, and clinical outcome of patients with advanced ovarian carcinoma.
authors.affiliation: Department of Procreative Medicine, Division of Gynecology and Obstetrics, University of Pisa, Via Roma 67, 56127 Pisa, Italy. a.gadducci@obgyn.med.unipi.it
authors.forename: Angiolo
authors.initials: A
authors.lastname: Gadducci
authors.forename: Paolo
authors.initials: P
authors.lastname: Viacava
authors.forename: Stefania
authors.initials: S
authors.lastname: Cosio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fanelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Fanucchi
authors.forename: Denise
authors.initials: D
authors.lastname: Cecchetti
authors.forename: Renza
authors.initials: R
authors.lastname: Cristofani
authors.forename: Andrea Riccardo
authors.initials: AR
authors.lastname: Genazzani
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology; D010051:Ovarian Neoplasms / Q000098:blood supply* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D015251:Epirubicin; D003520:Cyclophosphamide; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin