The role of vascular proliferation in the growth of brain tumors.

The formation of new blood vessels, i.e., angiogenesis, is a critical step in the evolution of a brain tumor from the earliest avascular phase to the clinically overt, vascular stage. For cerebral astrocytomas, intense capillary proliferation is a poor prognostic sign, associated with rapidly growing tumors. The in vivo production of a vasoformative substance can be demonstrated by transplanting human and experimental gliomas to the rabbit cornea. Intense neovascularization is elicited by the tumor and not by control tissues. If the same tumor is transplanted to the vitreous, thereby interrupting the vasoformative signal, the tumor remains in a dormant state for a prolonged period of time, despite its malignant potential. Inhibition of angiogenesis would be an important adjunct to the surgical treatment of gliomas.