Prognostic significance of tumor angiogenesis in endometrial cancer.

OBJECTIVE

To determine the prognostic effect of intratumor microvessel density in a series of unselected patients with endometrial carcinoma.

METHODS

We reviewed 93 consecutive patients treated surgically for endometrial cancer at the University Hospital of Vienna between 1983 and 1989. Histologic sections were obtained from original paraffin-embedded blocks and stained immunohistochemically for CD34 antigen. Microvessel density was determined by enumeration of intratumor CD34-positive cells under a light microscope at 200 x magnification using an examination area of 0.74 mm2. Log-rank test and Cox proportional-hazards models (univariate and multivariate) were applied for overall survival analysis.

RESULTS

Overall, the 25% quantile of survival was reached at 37.9 months. The 5-year survival rate was 82.2% in 69 patients whose tumors had microvessel counts no more than 100/0.74 mm2 field, and 52.0% in 24 patients whose tumors had microvessel counts of more than 100/0.74 mm2 field (log-rank P = .004). In the multiple Cox model, high microvessel counts (relative risk [RR] 1.2; 95% confidence interval [CI] 1.1, 1.4) as well as undifferentiated tumors (RR 6.1; CI 2.2, 16.8), and advanced stage of disease (RR 2.6; CI 1.3, 5.1) independently exerted an adverse influence on the survival of patients with endometrial cancer.

CONCLUSION

High intratumor microvessel count is associated with poor survival of patients with endometrial cancer.