Tumor angiogenesis as an independent prognostic factor after extended radical esophagectomy for invasive squamous cell carcinoma of the esophagus

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Background.Currently, there is only limited information regarding tumor angiogenesis and its clinical implications in cases of esophageal carcinoma. The purpose of this study was to clarify which clinicopathologic parameters correlate with tumor angiogenesis; furthermore, the study was conducted to evaluate whether tumor angiogenesis is an independent prognostic factor in cases of esophageal carcinoma.Methods.Intratumoral microvessel density (MVD) and thymidine phosphorylase (dThdPase) expression were immunohistochemically studied after extended radical esophagectomy in 103 cases of esophageal carcinoma.Results.Increased MVD significantly correlated with the depth of tumor invasion, the frequency of intramural metastasis, and the stage of tumor advancement (P < .05). dThdPase expression status significantly correlated with the size and depth of primary tumors (P < .02). A significant correlation was present between MVD and the expression status of dThdPase (P < .01). Furthermore, increased MVD correlated with increased tumor recurrence after esophagectomy and with poorer survival curves (P < .01 and P < .05, respectively). A multivariate analysis revealed MVD to be an independent predictor of unfavorable prognosis.Conclusions.Tumor angiogenesis expressed as MVD correlates with clinicopathologic parameters regarding tumor progression and is an independent prognostic indicator in patients undergoing extended radical esophagectomy for invasive esophageal carcinoma. (Surgery 2001;129:302-8.)

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