Poor outcome in hypoxic endometrial carcinoma is related to vascular density

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2019Author
Reijnen, Casper
Van Weelden, Willem Jan
Arts, Martijn S. J. P.
Peters, Johan P.
Rijken, Paul F.
van de Vijver, Koen
Santacana Espasa, Maria
Bronsert, Peter
Bulten, Johan
Hirschfeld, Marc
Colás, Eva
Gil-Moreno, Antonio
Reques, Armando
Mancebo, Gemma
Krakstad, Camilla
Trovik, Jone
Haldorsen, Ingfrid S
Huvila, Jutta
Koskas, Martin
Weinberger, Vit
Minar, Lubos
Jandakova, Eva
Snijders, Marc P. L. M.
van den Berg-van Erp, Saskia
Küsters-Vandevelde, Heidi V. N
Amant, Frederic
Massuger, Leon F. A. G.
Bussink, Johan
Pijnenborg, Johanna M. A.
Other authors
ENITEC consortium
Suggested citation
Reijnen, Casper;
Van Weelden, Willem Jan;
Arts, Martijn S. J. P.;
Peters, Johan P.;
Rijken, Paul F.;
van de Vijver, Koen;
...
Pijnenborg, Johanna M. A..
(2019)
.
Poor outcome in hypoxic endometrial carcinoma is related to vascular density.
British Journal of Cancer, 2019, núm. 120, p. 1037–1044.
https://doi.org/10.1038/s41416-019-0461-2.
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Show full item recordAbstract
BACKGROUND: Identification of endometrial carcinoma (EC) patients at high risk of recurrence is lacking. In this study, the prognostic role of hypoxia and angiogenesis was investigated in EC patients.
METHODS: Tumour slides from EC patients were stained by immunofluorescence for carbonic anhydrase IX (CAIX) as hypoxic marker and CD34 for assessment of microvessel density (MVD). CAIX expression was determined in epithelial tumour cells, with a cut-off of 1%. MVD was assessed according to the Weidner method. Correlations with disease-specific survival (DSS), disease-free survival (DFS) and distant disease-free survival (DDFS) were calculated using Kaplan–Meier curves and Cox regression analysis.
RESULTS: Sixty-three (16.4%) of 385 ECs showed positive CAIX expression with high vascular density. These ECs had a reduced DSS compared to tumours with either hypoxia or high vascular density (log-rank p = 0.002). Multivariable analysis showed that hypoxic tumours with high vascular density had a reduced DSS (hazard ratio [HR] 3.71, p = 0.002), DDFS (HR 2.68, p = 0.009) and a trend for reduced DFS (HR 1.87, p = 0.054).
CONCLUSIONS: This study has shown that adverse outcome in hypoxic ECs is seen in the presence of high vascular density, suggesting an important role of angiogenesis in the metastatic process of hypoxic EC. Differential adjuvant treatment might be indicated for these patients.
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British Journal of Cancer, 2019, núm. 120, p. 1037–1044European research projects
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