BACKGROUND: The purpose of this study was to retrospectively investigate tumor angiogenesis as a predictive marker for response to neoadjuvant chemotherapy, organ preservation, and survival in patients with advanced laryngeal carcinoma. METHODS: A total of 332 patients with stage III (188 patients) or stage IV (144 patients) squamous cell carcinoma of the larynx were entered in the prospective trial conducted by the Department of Veteran Affairs Laryngeal Cancer Study Group. Of this patient population, 20 pretreatment biopsy specimens were available from the chemotherapy arm for immunohistochemical analysis of Factor VIII expression. Two blinded investigators determined microvessel density in each patient by manual inspection of 10 high-power (400 x) fields (HPF). RESULTS: The patients who had a partial response (>50% decrease in tumor volume) or complete response to chemotherapy had a mean value of 20.90 (+/- 8.09 standard deviation [SD]) blood vessels per HPF. Those who did not respond to chemotherapy and thus required a total laryngectomy had a mean value of 32.99 (+/- 10.10 SD) vessels per HPF. The difference of the means was statistically significant using a two-tailed t test (P < .0085). Kaplan-Meier survival curve analysis also revealed that patients with vessel counts above the mean tended to have poorer survival than those below the mean regardless of treatment selection. The most-vascular tumors, those greater than 1 SD above the mean, had a statistically significant difference in survival and laryngeal preservation (P = .0345). CONCLUSIONS: These results indicate that tumor angiogenesis, as measured by number of vessels per HPF, was associated with decreased responsiveness to chemotherapy and radiation for larynx preservation. The most-vascular tumors also were associated with poorer survival than those with lesser degrees of angiogenesis.
RCT Entities:
BACKGROUND: The purpose of this study was to retrospectively investigate tumor angiogenesis as a predictive marker for response to neoadjuvant chemotherapy, organ preservation, and survival in patients with advanced laryngeal carcinoma. METHODS: A total of 332 patients with stage III (188 patients) or stage IV (144 patients) squamous cell carcinoma of the larynx were entered in the prospective trial conducted by the Department of Veteran Affairs Laryngeal Cancer Study Group. Of this patient population, 20 pretreatment biopsy specimens were available from the chemotherapy arm for immunohistochemical analysis of Factor VIII expression. Two blinded investigators determined microvessel density in each patient by manual inspection of 10 high-power (400 x) fields (HPF). RESULTS: The patients who had a partial response (>50% decrease in tumor volume) or complete response to chemotherapy had a mean value of 20.90 (+/- 8.09 standard deviation [SD]) blood vessels per HPF. Those who did not respond to chemotherapy and thus required a total laryngectomy had a mean value of 32.99 (+/- 10.10 SD) vessels per HPF. The difference of the means was statistically significant using a two-tailed t test (P < .0085). Kaplan-Meier survival curve analysis also revealed that patients with vessel counts above the mean tended to have poorer survival than those below the mean regardless of treatment selection. The most-vascular tumors, those greater than 1 SD above the mean, had a statistically significant difference in survival and laryngeal preservation (P = .0345). CONCLUSIONS: These results indicate that tumor angiogenesis, as measured by number of vessels per HPF, was associated with decreased responsiveness to chemotherapy and radiation for larynx preservation. The most-vascular tumors also were associated with poorer survival than those with lesser degrees of angiogenesis.
Authors: Gregory T Wolf; Emily Bellile; Avraham Eisbruch; Susan Urba; Carol R Bradford; Lisa Peterson; Mark E Prince; Theodoros N Teknos; Douglas B Chepeha; Norman D Hogikyan; Scott A McLean; Jeffery Moyer; Jeremy M G Taylor; Francis P Worden Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-04-01 Impact factor: 6.223
Authors: Bhavna Kumar; Kitrina G Cordell; Nisha D'Silva; Mark E Prince; Meredith E Adams; Susan G Fisher; Gregory T Wolf; Thomas E Carey; Carol R Bradford Journal: Arch Otolaryngol Head Neck Surg Date: 2008-04
Authors: Anke Schlüter; Patrick Weller; Oliver Kanaan; Ivonne Nel; Lukas Heusgen; Benedikt Höing; Pia Haßkamp; Sebastian Zander; Magis Mandapathil; Nina Dominas; Judith Arnolds; Boris A Stuck; Stephan Lang; Agnes Bankfalvi; Sven Brandau Journal: BMC Cancer Date: 2018-03-09 Impact factor: 4.430
Authors: T M Popov; T Dikov; T E Goranova; G Stancheva; R P Kaneva; S Todorov; O Stoyanov; J Rangachev; T Marinov; D P Popova; V I Mitev; D Konov Journal: Acta Otorhinolaryngol Ital Date: 2015-10 Impact factor: 2.124