TUMOR ANGIOGENESIS AS A PROGNOSTIC FACTOR IN LARYNGEAL-CANCER

BACKGROUND: Lymph node metastasis is the single greatest predictor of recurrence in laryngeal cancer. Prognostic factors are needed to targe t patients who may benefit from adjuvant therapy. Tumor angiogenesis c orrelates with metastasis in breast, bladder, and oral cavity cancer a nd may have prognostic value in other tumors. METHODS: In order to exa mine the relationship of tumor angiogenesis to recurrence, 51 patients with squamous cell carcinoma of the larynx were reviewed. In a blinde d design, previously sectioned slides were chosen for advanced tumor a nd highest vessel concentration. Samples were cut and immunocytochemic ally stained for CD-31 (an endothelial marker). A computer image analy zer quantitated the percent area of staining. Variables were statistic ally examined against recurrence. RESULTS: Patients were stratified by percent tumor staining. Nodal involvement was seen in 9 (36%) patient s with tumor staining less than or equal to 20% and in 20 (77%) with t umor staining > 20% (P = 0.003). Patients with less than or equal to 2 0% staining and without metastasis had a 13% rate of recurrence wherea s patients with > 20% staining and without metastasis had a 67% rate o f recurrence (P = 0.025). CONCLUSIONS: Though nodal status was suggest ive of predictability, only angiogenesis is a statistically significan t predictor of recurrence in node negative patients (P = 0.025). Angio genesis shows strong correlation with regional recurrence and may be u sed as an independent prognostic indicator to determine clinically nod e negative patients who may be at higher risk for metastasis and requi re adjuvant therapy. (C) 1997 by Excerpta Medica, Inc.