PURPOSE: Lymph node metastasis is an important prognostic factor in many types of cancer. Recently several specific markers for lymphatic endothelium were developed that facilitate the quantification of lymphangiogenesis in human cancer tissues. We investigated the clinical and prognostic significance of lymphangiogenesis in patients with transitional cell carcinoma of the upper urinary tract. MATERIALS AND METHODS: We measured lymph vessel density and relative lymphatic vascular area in 125 specimens by quantitative immunohistochemical staining for D2-40 antibody (DakoCytomation, Glostrup, Denmark). These parameters were examined in the intratumor and peritumor areas, and measured using image analysis software. RESULTS: Peritumor lymph vessel density and peritumor lymphatic vascular area correlated with lymph node metastasis and tumor grade. In the intratumor area lymphatic vessels were detected in only 16.0% of specimens. However, the presence of intratumor lymphatic vessels was associated with lymph node metastasis (p = 0.002). Multivariate analysis identified high peritumor lymphatic vascular area and the presence of intratumor lymphatic vessels as significant and independent factors of metastasis-free survival after surgery (OR = 5.11, p = 0.020 and OR = 2.92, p = 0.025, respectively). Multivariate analysis also identified the presence of intratumor lymphatic vessels as the only independent predictive factor of cause specific survival (OR = 3.89, p = 0.049). CONCLUSIONS: Lymphangiogenesis may have important roles in tumor metastasis and survival in patients with transitional cell carcinoma of the upper urinary tract. Quantification of lymphatic vessels, especially peritumor lymphatic vascular area and intratumor lymphatic vessels, was useful for predicting metastasis-free survival. In addition, the presence of intratumor lymphatic vessels was an independent predictor of cause specific survival.
PURPOSE: Lymph node metastasis is an important prognostic factor in many types of cancer. Recently several specific markers for lymphatic endothelium were developed that facilitate the quantification of lymphangiogenesis in humancancer tissues. We investigated the clinical and prognostic significance of lymphangiogenesis in patients with transitional cell carcinoma of the upper urinary tract. MATERIALS AND METHODS: We measured lymph vessel density and relative lymphatic vascular area in 125 specimens by quantitative immunohistochemical staining for D2-40 antibody (DakoCytomation, Glostrup, Denmark). These parameters were examined in the intratumor and peritumor areas, and measured using image analysis software. RESULTS: Peritumor lymph vessel density and peritumor lymphatic vascular area correlated with lymph node metastasis and tumor grade. In the intratumor area lymphatic vessels were detected in only 16.0% of specimens. However, the presence of intratumor lymphatic vessels was associated with lymph node metastasis (p = 0.002). Multivariate analysis identified high peritumor lymphatic vascular area and the presence of intratumor lymphatic vessels as significant and independent factors of metastasis-free survival after surgery (OR = 5.11, p = 0.020 and OR = 2.92, p = 0.025, respectively). Multivariate analysis also identified the presence of intratumor lymphatic vessels as the only independent predictive factor of cause specific survival (OR = 3.89, p = 0.049). CONCLUSIONS: Lymphangiogenesis may have important roles in tumor metastasis and survival in patients with transitional cell carcinoma of the upper urinary tract. Quantification of lymphatic vessels, especially peritumor lymphatic vascular area and intratumor lymphatic vessels, was useful for predicting metastasis-free survival. In addition, the presence of intratumor lymphatic vessels was an independent predictor of cause specific survival.
Authors: Thomas F Chromecki; Behfar Ehdaie; Giacomo Novara; Karl Pummer; Richard Zigeuner; Christian Seitz; Armin Pycha; Richard K Lee; Eugene K Cha; Pierre I Karakiewicz; Casey Ng; Jay D Raman; Felix K Chun; Hans-Martin Fritsche; Kazumasa Matsumoto; Wassim Kassouf; Thomas J Walton; Patrick J Bastian; Juan I Martínez-Salamanca; Douglas S Scherr; Shahrokh F Shariat Journal: World J Urol Date: 2011-04-17 Impact factor: 4.226
Authors: David S Yee; Shahrokh F Shariat; William T Lowrance; Alexandra C Maschino; Caroline J Savage; Angel M Cronin; Peter T Scardino; James A Eastham Journal: BJU Int Date: 2010-11-02 Impact factor: 5.588
Authors: Eiji Kikuchi; Vitaly Margulis; Pierre I Karakiewicz; Marco Roscigno; Shuji Mikami; Yair Lotan; Mesut Remzi; Christian Bolenz; Cord Langner; Alon Weizer; Francesco Montorsi; Karim Bensalah; Theresa M Koppie; Mario I Fernández; Jay D Raman; Wassim Kassouf; Christopher G Wood; Nazareno Suardi; Mototsugu Oya; Shahrokh F Shariat Journal: J Clin Oncol Date: 2008-12-15 Impact factor: 44.544
Authors: Deborah W Knapp; Larry G Adams; Alec M Degrand; Jacqueline D Niles; José A Ramos-Vara; Ann B Weil; Michael A O'Donnell; Michael D Lucroy; John V Frangioni Journal: Eur Urol Date: 2007-07-16 Impact factor: 20.096