Neovascularisation is a prognostic factor of early recurrence in T1/G2 urothelial bladder tumours.
BACKGROUND
Of patients with superficial bladder cancer, a group are still at risk of disease recurrence, progression and death from their cancer after curative treatment. Angiogenesis is a crucial pathogenic mechanism for this type of urothelial cell carcinoma (UCC), and is a potential therapeutic target. However, the selection of the appropriate patients remains a dilemma.


METHODS
Vascular endothelial growth factor (VEGF) expression and the presence of angiogenesis and occurrence of CD31, CD34, endoglin and factor VIII immunoexpression, were evaluated in 66 superficial papillary UCCs of the bladder and were correlated with classical histopathological factors and disease outcome.


RESULTS
VEGF immunoreactivity was observed in 100% of cases, and more intensely in the luminal surface. The presence of microvessel clusters independently of a fibrovascular core was observed in 22.7% of cases. Of these, the T1/G2 subgroup had an independent and significantly lower recurrence-free survival (P = 0.0002).


CONCLUSIONS
These results indicate that the presence of angiogenesis in tumour urothelium is a potential prognostic factor in superficial UCC, particularly in T1/G2 tumours, and may be used to select patients for anti-angiogenic treatments.
Santos
L
L
Department of Surgical Oncology, Portuguese Institute of Oncology, Porto, Portugal. ucib@ipoporto.min-saude.pt
Costa
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C
Pereira
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S
Koch
M
M
Amaro
T
T
Cardoso
F
F
Guimarães
T
T
Bento
M J
MJ
Lobo
F
F
Pinto
S
S
Lopes
C
C
D015703:Antigens, CD; D018952:Antigens, CD34 / Q000032:analysis; D000071063:Endoglin; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009364:Neoplasm Recurrence, Local; D009389:Neovascularization, Pathologic; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D011379:Prognosis; D011956:Receptors, Cell Surface; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000098:blood supply* / Q000401:mortality / Q000473:pathology; D019459:Urothelium / Q000098:blood supply* / Q000473:pathology; D019010:Vascular Cell Adhesion Molecule-1 / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
D015703:Antigens, CD; D018952:Antigens, CD34; C064206:ENG protein, human; D000071063:Endoglin; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D011956:Receptors, Cell Surface; D019010:Vascular Cell Adhesion Molecule-1; D042461:Vascular Endothelial Growth Factor A