TUMOR ANGIOGENESIS IN STAGE IB CERVICAL-CANCER - CORRELATION OF MICROVESSEL DENSITY WITH SURVIVAL

OBJECTIVE: Because angiogenesis is considered essential for tumor grow th and the development of metastasis, we assessed the correlation of m icrovessel density with overall survival in patients with clinical sta ge is carcinoma of the uterine cervix. STUDY DESIGN: Histologic slides were immunostained for factor VIII-related antigen. Microvessel densi ty was determined within each tumor by enumeration under a light micro scope at 200x magnification and an examination area of 0.25 mm(2). The Cox proportional hazards model was used for multivariate analysis. RE SULTS: In 166 patients with stage IB cervical cancer the 5-year surviv al was as follows: 89.7% in 102 patients whose tumors had a microvesse l density less than or equal to 20/field, and 63.0% in 64 patients who se tumors bad a microvessel density >20/field (log rank p < 0.0001), I n the multivariate Cox model microvessel density, lymph node involveme nt, tumor size, and the application of radiation therapy remained inde pendent prognostic factors for survival, whereas lymphatic vascular sp ace involvement failed to retain a significant value. CONCLUSION: High microvessel density adversely influences patients' survival in clinic al stage IB cervical cancer and identifies patients with negative node s at risk for relapse.