Prognostic significance of tumor angiogenesis in endometrial cancer

Objective: To determine the prognostic effect of intratumor microvessel den sity in a series of unselected patients with endometrial carcinoma. Methods: We reviewed 93 consecutive patients treated surgically for endomet rial cancer at the University Hospital of Vienna between 1983 and 1989. His tologic sections were obtained from original paraffin-embedded blocks and s tained immunohistochemically for CD34 antigen. Microvessel density was dete rmined by enumeration of intratumor CD34-positive cells under a light micro scope at 200 x magnification using an examination area of 0.74 mm(2). Log-r ank test and Cox proportional-hazards models (univariate and multivariate) were applied for overall survival analysis. Results: Overall, the 25% quantile of survival was reached at 37.9 months. The 5-year survival rate was 82.2% in 69 patients whose tumors had microves sel counts no more than 100/0.74 mm(2) field, and 52.0% in 24 patients whos e tumors had microvessel counts of more than 100/0.74 mm(2) field (log-rank P = .004). In the multiple Cox model, high microvessel counts (relative ri sk [RR] 1.2; 95% confidence interval [CI] 1.1, 1.4) as well as undifferenti ated tumors (RR 6.1; CI 2.2, 16.8), and advanced stage of disease (RR 2.6; CI 1.3, 5.1) independently exerted an adverse influence on the survival of patients with endometrial cancer. Conclusion: High intratumor microvessel count is associated with poor survi val of patients with endometrial cancer. (C) 1999 by The American College o f Obstetricians and Gynecologists.