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Annals of Oncology 14:1419-1424, 2003
© 2003 European Society for Medical Oncology

Original Paper

Neovascularisation is a prognostic factor of early recurrence in T1/G2 urothelial bladder tumours

L. Santos1,+, C. Costa2, S. Pereira2, M. Koch2, T. Amaro2, F. Cardoso3, T. Guimarães3, M. J. Bento4, F. Lobo1, S. Pinto3 and C. Lopes2

Departments of 1 Surgical Oncology, 2 Pathology, 3 Medical Oncology and 4 Epidemiology, Portuguese Institute of Oncology, Porto, Portugal

Received 19 December 2002; revised 24 April 2003; accepted 3 June 2003

Background:

Of patients with superficial bladder cancer, a group are still at risk of disease recurrence, progression and death from their cancer after curative treatment. Angiogenesis is a crucial pathogenic mechanism for this type of urothelial cell carcinoma (UCC), and is a potential therapeutic target. However, the selection of the appropriate patients remains a dilemma.

Patients and methods:

Vascular endothelial growth factor (VEGF) expression and the presence of angiogenesis and occurrence of CD31, CD34, endoglin and factor VIII immunoexpression, were evaluated in 66 superficial papillary UCCs of the bladder and were correlated with classical histopathological factors and disease outcome.

Results:

VEGF immunoreactivity was observed in 100% of cases, and more intensely in the luminal surface. The presence of microvessel clusters independently of a fibrovascular core was observed in 22.7% of cases. Of these, the T1/G2 subgroup had an independent and significantly lower recurrence-free survival (P = 0.0002).

Conclusions:

These results indicate that the presence of angiogenesis in tumour urothelium is a potential prognostic factor in superficial UCC, particularly in T1/G2 tumours, and may be used to select patients for anti-angiogenic treatments.

Key words: angiogenesis, bladder cancer, prognosis, vascular endothelial growth factor


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