Angiogenesis and p53 at the invading tumor edge: Prognostic markers for colorectal cancer beyond stage

Background. Angiogenesis has emerged as a major prognostic factor in many human malignancies and it is a prospective target for cancer therapy. Materials and methods. In this study, we investigated immunohistochemically the angiogenic activity and the expression of p53 and bcl-2 proteins in a series of 170 operable colorectal carcinomas, stage B and C. Results. A high vascular density at the invading tumor front was directly related to nuclear p53 accumulation, and inversely to cytoplasmic expression of bcl-2. Furthermore, high angiogenic activity was significantly associated with lymph node metastasis. Survival analysis showed that Dukes stage and vascular density were the most important and independent prognostic factors in colorectal cancer. Discussion. It is believed that angiogenesis at the invading tumor edge can be used as an independent prognostic marker to identify subgroups of colorectal cancer patients with an unfavorable post-operative outcome. (c) 2006 Elsevier Inc. All rights reserved.