Tumor angiogenesis and prognosis in squamous cell carcinoma of the head and neck.

The progression of tumor growth requires the recruitment of new blood vessels. It has been suggested that the degree of neovascularization would correlate with clinical prognosis. The purpose of the present study was to ascertain whether tumor vascularization correlated with clinical outcome in cases of primary squamous cell carcinoma of the head and neck (SCCHN). In tumor biopsies from 48 patients, microvessel density was determined by immunohistochemistry based on polyclonal antibodies against factor VIII related endothelial antigen. Computerized image analysis was used to evaluate the staining intensity per histologic area. The degree of staining was quantitated and expressed as microvessel density, low and high microvessel density subgroups being compared with regard to survival. Median survival was 10 months in the subgroup with very low microvessel density scores, as contrasted to 69 months in the remainder with high scores (p = 0.08). Neither the patient's age, TNM status, clinical stage, nor histologic grade was related to microvessel density. Among the patients who eventually died of SCCHN (n = 23), there was a subgroup of patients with complete response to radiotherapy. This subgroup had significantly higher microvessel density and longer survival than did the patients who responded poorly or not at all to radiotherapy. The findings suggest that in SCCHN the degree of vascularization might be used as a predictor of response to radiotherapy.