Prognostic significance of tumour vascularisation on survival of patients with advanced ovarian carcinoma.
The prognostic significance of microvessel density in ovarian cancer is still a matter of debate. Classically, the degree of vascularisation is assessed in areas of high vascular density (hot spots), considered as regions of increased probability of metastasis. Since ovarian tumours have a particular progression and dissemination behaviour, vascularisation outside hot spots may also contribute to their evolution.



In the present study, the degree of tumour vascularisation was estimated both in whole histogical sections and in hot spots, in 235 patients with ovarian carcinoma, using fully automatic image analysis methods. Six parameters were estimated: mean microvessel density (MVD) and mean microvessel surface fraction (MSP) on the whole section, mean and maximum values of MVD and MSP inside hot spots (MVDHS1, MSPHS1 and MVDHS2, MSPHS2). Relationships between vascular parameters and clinicopathologic features were analysed.



In stage III-IV patients multivariate analysis showed that stage IV disease (hazards ratio (HR)=1.72, p=0.001), post-surgical residual disease 1cm (HR=2.86, p<0.001), upper MVD tercile (HR=1.45, p<0.022) and medial MVDHS1 tercile (HR=1.36, p=0.060) retained an independent prognostic value upon overall survival.



Our results suggest that quantification of blood vessels, both on the whole histological section and in hot spots might be helpful in evaluating prognosis in advanced ovarian carcinomas.
Labiche
Alexandre
A
Groupe Régional d'Etudes sur le Cancer (GRECAN - EA 1772, IFR 146 ICORE), Université de Caen-Basse Normandie, Centre François Baclesse, Caen, France. a.labiche@baclesse.fr
Elie
Nicolas
N
Herlin
Paulette
P
Denoux
Yves
Y
Crouet
Hubert
H
Heutte
Natacha
N
Joly
Florence
F
Héron
Jean-François
JF
Gauduchon
Pascal
P
Henry-Amar
Michel
M
D000230:Adenocarcinoma / Q000098:blood supply* / Q000401:mortality* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000401:mortality* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000098:blood supply* / Q000401:mortality* / Q000473:pathology; D011379:Prognosis