The prognostic significance of angiogenesis in epithelial ovarian carcinoma

The molecular biology underlying the metastatic process in ovarian carcinom a remains poorly understood. For other neoplasms, the induction of angiogen esis by malignant cells has been shown to play a pivotal role in the proces s of tumor proliferation and metastasis, The purpose of this study was to c haracterize the degree of angiogenesis in epithelial ovarian malignancies a nd to determine whether the degree of neovascularization has prognostic sig nificance for survival, Tissue sections obtained from 88 ovarian cancer patients were examined immu nohistochemically for angiogenesis after staining with anti-human endotheli al cell antibodies to von Willebrand factor and CD31, Light microscopy was performed, and individual microvessel counts were quantified at high power (x400), A chart review was completed, collating data regarding age, stage, grade, status of disease, and survival. Statistical exploratory methods wer e used to find potentially useful prognostic cutpoints for marker values of angiogenesis, Of the total 88 patients, tissue microvessel counts from 85 were evaluated via antibodies to von Willebrand factor and 87 for CD31, Overall, median su rvival was 2.7 years in women with cancers containing high microvessel coun ts versus 7.9 gears in those with low microvessel counts (P = 0.03). A low microvessel count was associated with better 5-year survival in both early stage (I and II) and advanced stage (III and IV) disease. Our data suggest that the degree of neovascularization may have prognostic significance in epithelial ovarian carcinoma, especially for women with ear ly-stage disease. In this group of women, the degree of angiogenesis may al low the selection of women at high risk for recurrence who may benefit from aggressive adjuvant therapy.