Tumor angiogenesis as an independent prognostic factor after extended radical esophagectomy for invasive squamous cell carcinoma of the esophagus

Background. Currently; there is only limited information regarding tumor an giogenesis and its clinical implications in cases of esophageal carcinoma. The purpose of this study was to clarify which clinico-pathologic ic parame ters correlate with tumor angiogenesis; furthermore, the study was conducte d to evaluate whether tumor angiogenesis is an independent prognostic facto r in cases of esophageal carcinoma. Methods. Intratumoral microvessel density (MVD) and thymidine phosphorylase (dThdPase) expression were immunohistochemically studied after extended ra dical esophagectomy in ICN cases of esophageal carcinoma. Results. Increased MVD significantly correlated with the depth of tumor inv asion the frequency of intramural metastasis, and the stage of tumor advanc ement (P < . 05). dThdPase expression status significantly correlated with the size and depth of primary tumors (P < .02). A significant correlation w as present between MVD and the expression status of dThdPase (P < .01). Fur thermore, increased MVD correlated with increased tumor recurrence after es ophagectomy and with poorer. survival curves (P < .01 and P < .05, respecti vely). A multivariate analysis revealed MVD to be an independent predictor of unfavorable prognosis. Conclusions. Tumor angiogenesis expressed as MVD correlates with clinicopat hologic parameters regarding tumor progression and is an independent progno stic indicator in patients undergoing extended radical esophagectomy for in vasive esophageal carcinoma.