Ra. Cooper et al., Tumour vascularity is a significant prognostic factor for cervix carcinomatreated with radiotherapy: independence from tumour radiosensitivity, BR J CANC, 81(2), 1999, pp. 354-358
The aim of the study was to investigate the relationship between intrinsic
radiosensitivity and vascularity in carcinoma of the cervix given radiother
apy, and assess whether more refined prognostic information can be gained b
y combining the two parameters. A retrospective study was carried out on 74
patients with locally advanced carcinoma of the cervix. Formalin-fixed, pa
raffin-embedded tumour biopsies were stained with anti-factor VIII using im
munohistochemistry. Vascularity was scored using the intra-tumour microvess
el density (IMD), or 'hotspot', technique. For the same patients, the measu
rement of intrinsic radiosensitivity (SF2) had been made previously on the
same pretherapy samples. Patients were stratified by the median IMD and SF2
scores. Women with radioresistant and highly vascular tumours had poorer 5
-year survival (P = 0.0005, P = 0.035 respectively) and local control (P =
0.012, P = 0.077 respectively) than those with radiosensitive and poorly va
scular tumours. No significant correlation was seen between IMD and SF2. Mu
ltivariate analysis (including tumour stage and patient age) showed that on
ly SF2 and IMD were significant prognostic factors for survival. Patients w
ith both a radioresistant and highly vascular tumour had a 5-year survival
level of 18% compared to 77% for those patients with a radiosensitive and p
oorly vascularized tumour. Tumour angiogenesis and cellular radiosensitivit
y are independent prognostic factors for cervix carcinoma treated with radi
otherapy. Allowing for tumour radiosensitivity increases the prognostic sig
nificance of vascularity measurements in cervix tumours. (C) 1999 Cancer Re
search Campaign.