Tumor angiogenesis as a prognostic factor in laryngeal cancer**

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background

Lymph node metastasis is the single greatest predictor of recurrence in laryngeal cancer. Prognostic factors are needed to target patients who may benefit from adjuvant therapy. Tumor angiogenesis correlates with metastasis in breast, bladder, and oral cavity cancer and may have prognostic value in other tumors.

methods

In order to examine the relationship of tumor angiogenesis to recurrence, 51 patients with squamous cell carcinoma of the larynx were reviewed. In a blinded design, previously sectioned slides were chosen for advanced tumor and highest vessel concentration. Samples were cut and immunocytochemically stained for CD-31 (an endothelial marker). A computer image analyzer quantitated the percent area of staining. Variables were statistically examined against recurrence.

results

Patients were stratified by percent tumor staining. Nodal involvement was seen in 9 (36%) patients with tumor staining ≤ 20% and in 20 (77%) with tumor staining > 20% (P = 0.003). Patients with ≤ 20% staining and without metastasis had a 13% rate of recurrence whereas patients with > 20% staining and without metastasis had a 67% rate of recurrence (P = 0.025).

conclusions

Though nodal status was suggestive of predictability, only angiogenesis is a statistically significant predictor of recurrence in node negative patients (P = 0.025). Angiogenesis shows strong correlation with regional recurrence and may be used as an independent prognostic indicator to determine clinically node negative patients who may be at higher risk for metastasis and require adjuvant therapy.

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    • Vascularity Index of Laryngeal Cancer Derived from 3-D Ultrasound: A Predicting Factor for the in vivo Assessment of Cervical Lymph Node Status

      2009, Ultrasound in Medicine and Biology
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      Thus, the purpose of this study was to find a parameter that was complementary or would surpass the current assessment of lymph node status. Murray et al. (1997) and Kupisz et al. (1999) investigated the sectioned slides of laryngeal cancer and reported that the degree of angiogenesis may become a reliable independent indicator that can be used to predict nodal status, tumor recurrence and possibly survival. To our knowledge, there are no available documents describing the use of sonography to assess angiogenesis or vascularity in laryngeal cancer.

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    **

    Presented at the 43rd Annual Meeting of the Society of Head and Neck Surgeons, Cancún, Mexico, April 10–12, 1997.

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