TUMOR ANGIOGENESIS IN ADVANCED-STAGE OVARIAN-CARCINOMA

Tumor angiogenesis has been found to have prognostic significance in many tumor types for predicting an increased risk of metastasis. We assessed tumor vascularity in 43 cases of advanced stage (International Federation of Gynecologists and Obstetricians stages III and IV) ovarian cancer by using the highly specific endothelial cell marker CD34. Microvessel counts and stage were associated with disease-free survival and with overall survival by Kaplan-Meier analysis. The plots show that higher stage, higher average vessel count at 200 x (200 x avg) and 400 x (400 x avg) magnification and highest vessel count at 400 x (400 x high) magnification confer a worse prognosis for disease-free survival Average vessel count of less than 16(400 x avg, P-2 = 0.01) and less than 45 (200 x avg, P, = 0.026) suggested a better survival: Similarly, a high vessel count of less than 20 (400 x high, P-2 = 0.019) conferred a better survival as well. The plots suggest that higher stage, higher average vessel count at 200 x and 400 x, and highest vessel count at 200 x and 400 x show a trend to worse overall survival as well. With the Cox proportional hazards model, stage was the best predictor of overall survival, however, the average microvessel count at 400 x was found to be the best predictor of disease-free survival. These results suggest that analysis of neovascularization in advanced stage ovarian cancer may be a useful prognostic factor.