The prognostic significance of tumor vascularization in patients with localized colorectal cancer

Angiogenesis is essential for tumor growth and metastasis, and vascular den sity is known as an independent prognostic factor in several tumor entities . We studied the prognostic relevance of vascular density in colorectal can cer, examining 146 patients treated surgically for cure. Tumor sections wer e immunostained with JC70, an endothelial cell marker. Microvessel quantifi cation used light microscopy. The slides were scanned at a low magnificatio n, and individual microvessel counts were made on a x200 field in the area of the most dense neovascularization. Vascular density was found to be 75+/ -27/visual field and to be independent of age, sex, pT. and pN categories, tumor recurrence, and overall survival. Overall survival in the subgroup of patients with tumor recurrence was significantly shorter with tumors of gr eater vessel density (>75) than in those of less vessel density (<75). Mult ivariate analysis showed microvessel count to be an independent prognostic factor for the overall survival rate of patients with tumor recurrence; amo ng these patients there was also a significant difference in the relapse-fr ee survival rates between the hypovascular and the hypervascular groups. Ou r findings suggest that the microvessel density of the primary tumor determ ines the speed of tumor recurrence after metastatic disease has been trigge red by other, unknown mechanisms. Although tumor vascularization can be lin ked to the aggressiveness of colorectal cancer, it has no value as a new pr ognostic marker in clinical practice.