Mc. Hall et al., SIGNIFICANCE OF TUMOR ANGIOGENESIS IN CLINICALLY LOCALIZED PROSTATE CARCINOMA TREATED WITH EXTERNAL-BEAM RADIOTHERAPY, Urology, 44(6), 1994, pp. 869-875
Objectives. To determine the prognostic significance of microvessel de
nsity (a measure of tumor angiogenesis) in comparison with other progn
ostic factors for patients with clinically localized prostatic carcino
ma treated with external beam radiotherapy. Methods. Microvessel densi
ty was quantified within the initial invasive carcinoma from the diagn
ostic transurethral resection specimen of 25 patients with a mean foll
ow-up of 44 months. Microvessels were identified by immunohistochemica
l staining of endothelial cells for factor VIII-related antigen in for
malin-fixed, paraffin-embedded tissue. Microvessels were counted in a
x200 field (0.754 mm(2)) in the area of maximal angiogenesis. Results.
Microvessel density correlated with several pretreatment prognostic f
actors, including prostate-specific antigen (PSA) (p < 0.0001), tumor
grade (p = 0.006), and ploidy (p = 0.016). The degree of tumor angioge
nesis also correlated with outcome following external beam radiotherap
y. The mean microvessel count in the nine tumors from patients who fai
led radiotherapy tie, had rising PSA and/or clinical relapse) was 97.0
+/- 33.6 (+/- SD) per x200 field compared with 46.1 +/- 17.1 for the
16 patients with nand evidence of failure (p < 0.0001). Increased micr
ovessel density was also associated with a significantly worse actuari
al outcome at 4 years using either biochemical relapse (rising PSA) or
a composite endpoint of rising PSA or clinical relapse (p = 0.0005).
Conclusions. The intratumoral quantification of tumor angiogenesis may
prove valuable as a prognostic indicator in patients with clinically
localized prostate cancer treated with radiotherapy.