Aims: Angiogenesis is a multistep phenomenon, critical for tumor growth and prognosis in many solid neoplasms. Microvessels density (MVD) is a method of assessing angiogenesis and adversely affects DFS and OS in breast, lung and colorectal cancer. Few data are available in STS in which stage and grading are until now fundamental.
Methods: Our perspective study determined the level of MVD in a series of STS and correlated these results with DFS and OS, comparing its prognostic value with grading and stage. MVD was determined with CD 31 immunostains in formalin fixed, paraffin embedded tissues. Intratumoral MVD was assessed by light microscopic analysis. Hot spots defined the positive areas. The study included 45 patients, 35 with localized and 10 with metastatic disease at diagnosis. All tumors were located in upper or lower extremities. Histology were: 13 liposarcoma,11 MFH, 5 leiomiosarcoma, 5 PNST, 3 rabdo, 3 synovialsarcoma, 3 undifferentiated and 2 fibrosarcoma. Following Coindre classification 23 pts had low grade and 22 high grade STS.
Results: median follow up is 23 months (2–84). At present 20 pts (44.4%) are alive and DF, 11 (24.4%) alive with disease, 14 (31.1%) dead. Median survival is 75 months. Median MVD of all specimens is 62 microvessels/mm2 (7–161). 32 pts (71.1%) have low MVD (group A) and 13 pts (29.9%) high MVD (group B). Mean survival is 62.7 mo in group A (median 75) and 36 mo in group B (median not reached) (p 0.01); median DFS respectively 24 mo and 15 mo (p 0.01). There is also a significant association with histological grade and survival: 75 mo in low grade and 34 mo in high grade tumors (p 0.05) and presence of metastasis at diagnosis (median survival: M+23 mo, M−75 mo). Unfortunately no relationship between angiogenesis and grading is found.
Conclusions: Our study confirms the prognostic importance of grade and staging in pts with STS. Moreover the role of MVD in prognosis is well defined and should be used as a routine marker in STS histological diagnosis.
