Cancers of the Respiratory Tract

Macchiarini et al. (79) first assessed whether the degree of angiogenesis correlates with metastasis in nonsmall-cell lung cancer (NSCLC). They determined intratumoral microvessel density in a series of 87 patients with initial tumor stage T1N0M0 who underwent radical surgery. The 22 patients who developed recurrence during the follow-up period had tumors with a statistically higher vascularization, compared to those alive and disease-free. Seven subsequent studies (80-86) investigated the prognostic significance of vascularization in NSCLC, and, in all the series, the patients with radically resected, highly vascularized primary tumors had poorer prognosis, compared to those with low angiogenic tumors (Table 4). Of particular interest were the studies by Apolinario et al. (84), suggesting that the prognostic value of neovascularization is more relevant in patients with stage II disease, and that the degree of angiogenesis was not related to the other biological (p53, bcl-2, and bax oncoproteins) or pathological markers studied.

Fontanini et al. (85) recently published results obtained in a very large series (470 patients) with stages I-III NSCLC. On multivariate analysis, intratumoral microvessel density, tumor size, and regional lymph node status all retained independent prognostic value for overall survival. In another study, Fontanini et al. (86) also found that highly vascularized tumors had a significantly more elevated nuclear expression of p53 protein, and more elevated levels of VEGF. Microvessel count retained statistically prognostic value in a multivariate statistical model, also including the other biological variables above.

Table 5

Prognostic Value of Microvessel Density in Genitourinary Cancers

Table 5

Prognostic Value of Microvessel Density in Genitourinary Cancers

Author

Endothelial marker

No. pts.

Stage

Median follow-up (mo)

Prognostic value

Ref.

Testicular germinal cell tumor

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