Cancers of Head and Neck

Albo et al. (117) studied angiogenesis in a small series of patients with squamous cell carcinomas of the head and neck, using fVIII-RA to stain microvessels. They found that the patients with highly vascularized primary tumors had a significantly higher frequency of recurrent or metastatic disease than those with low angiogenic cancers. A subsequent study by Williams et al. (118) found that angiogenesis is a significant prognostic indicator of recurrence in a series of 66 patients with oral cavity tumors.

Klijanienko et al. (119) assessed vascularization of 114 primary head and neck squamous cell carcinomas by morphologic criteria without a specific endothelial marker. In this series, tumor vascularization correlated with tumor mitotic index, nuclear grade, peritumoral vessel invasion, and lymph node involvement. The authors concluded that tumor vascularization is an important histologic feature associated with the biological aggressiveness of such type of tumors.

Gasparini et al. (120) determined several predictive and prognostic markers in 73 patients with head and neck squamous cell invasive carcinoma, who were treated with concurrent cisplatin or carboplatin and radiation therapy for stage II-IV disease. Vascularization was assessed by the anti-CD31 antibody, and it was significantly predictive of the probability of response to therapy, but not of prognosis. The patients with highly vascularized primary tumors had a significantly lower probability of obtaining a complete response with therapy, compared to those with low angiogenic cancers. In addition, the degree of microvessel density did not correlate with bcl-2 expression or PCNA labeling rate, but it was significantly associated with p53 expression. As found in another report by the same investigators (121), both microvessel density and p53 protein expres-

Table 7

Prognostic Value of Microvessel Density in Head and Neck Cancer

Table 7

Prognostic Value of Microvessel Density in Head and Neck Cancer

Author

Endothelial marker

No. pts.

Stage

Median follow-up (mo)

Prognostic value

Ref.

Albo

fVIII-RA

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