TUMOR ANGIOGENESIS AND PROGNOSIS IN SQUAMOUS-CELL CARCINOMA, OF THE HEAD AND NECK

Background. The progression of tumor growth requires the recruitment o f new blood vessels. it has been suggested that the degree of neovascu larization would correlate with clinical prognosis. The purpose of the present study was to ascertain whether tumor vascularization correlat ed with clinical outcome in cases of primary squamous cell carcinoma o f the head and neck (SCCHN). Methods. In tumor biopsies from 48 patien ts, microvessel density was determined by immunohistochemistry based o n polyclonal antibodies against factor VIII related endothelial antige n. Computerized image analysis was used to evaluate the staining inten sity per histologic area. The degree of staining was quantitated and e xpressed as microvessel density, low and high microvessel density subg roups being compared with regard to survival. Results. Median survival was 10 months in the subgroup with very low microvessel density score s, as contrasted to 69 months in the remainder with high scores (p = 0 .08). Neither the patient's age, TNM status, clinical stage, nor histo logic grade was related to microvessel density. Among the patients who eventually died of SCCHN (n = 23), there was a subgroup of patients w ith complete response to radiotherapy. This subgroup had significantly higher microvessel density and longer survival than did the patients who responded poorly or not at all to radiotherapy. Conclusion. The fi ndings suggest that in SCCHN the degree of vascularization might be us ed as a predictor of response to radiotherapy.