title: Microvessel density >or=60 does not predict for outcome after radiation treatment for locally advanced head and neck squamous cell carcinoma: results of a correlative study from the Radiation Therapy Oncology Group (RTOG) 90-03 Trial.
abstract: OBJECTIVE
  To assess whether microvessel density (MVD), an immunohistochemical marker for tumor vascularity, predicts for radiotherapy (RT) outcome in locally advanced HNSCC patients.
  
  
  METHODS
  A total of 459 patients, enrolled on the RTOG 90-03 trial, had biopsy specimens submitted, and a value for MVD determined, prior to definitive RT. 450 patients were analyzable for this study. Tumor microvessels were stained for factor VIII-related antigen using a standard immunoperoxidase method. The mean number of stained microvessel profiles, from three x200 fields containing the highest MVD (hot spot), was recorded as the MVD. A prospective value of >or=60 was chosen as the threshold for high MVD, tumor vascularity.
  
  
  RESULTS
  The median follow-up for the analyzable patients with MVD assessment was 22.0 months and 79.1 months for all living patients. There were no differences concerning the pretreatment characteristics between those RTOG 90-03 patients with a value for MVD and those without a value for MVD. Thus, the present study cohort possessed comparable characteristics with the entire RTOG 90-03 population. MVD values ranged from 5 to 80, with a median value of 30. Only 37 of 450 (8.2%) patients possessed an MVD >or=60. There were no outcome differences for patients with MVD <60 versus >or=60 on multivariate analysis for time to local-regional failure (P = 0.89), time to distant metastasis (P = 0.80), disease-free survival (P = 0.46), and overall survival (P = 0.39).
  
  
  CONCLUSIONS
  In this large, correlative study, a MVD >or=60, ie, high tumor vascularity, did not predict for outcome in locally advanced head and neck squamous cell carcinoma patients treated with radiotherapy.
authors.affiliation: Lakeland Regional Cancer Center, Lakeland, FL 33804-1057, USA. douglas.calvin@lrmc.com
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Calvin
authors.forename: M E
authors.initials: ME
authors.lastname: Hammond
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Pajak
authors.forename: Andy M
authors.initials: AM
authors.lastname: Trotti
authors.forename: Ruby F
authors.initials: RF
authors.lastname: Meredith
authors.forename: Marvin
authors.initials: M
authors.lastname: Rotman
authors.forename: Christopher U
authors.initials: CU
authors.lastname: Jones
authors.forename: Roger W
authors.initials: RW
authors.lastname: Byhardt
authors.forename: W F
authors.initials: WF
authors.lastname: Demas
authors.forename: K Kian
authors.initials: KK
authors.lastname: Ang
authors.forename: Karen K
authors.initials: KK
authors.lastname: Fu
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000532:radiotherapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000098:blood supply* / Q000532:radiotherapy; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism*; D015996:Survival Rate; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D014841:von Willebrand Factor