TUMOR ANGIOGENESIS AS A PROGNOSTIC FACTOR IN ORAL CAVITY TUMORS

BACKGROUND: Lymph-node metastasis is the single greatest predictor of survival in patients with oral cavity cancers. Tumor angiogenesis has been correlated with metastasis in breast cancer and may have prognostic value in other tumors. PATIENTS AND METHODS: Sixty-six patients with clinically node-negative oral cavity squamous cell cancers were reviewed. Samples were cut and stained for factor VIII. The percentage of area of tissue stained for factor VIII was quantitated by a computerized image analyzer. Tumor depth was measured with an ocular micrometer to the nearest 0.1 mm. Variables were statistically examined against regional recurrence. RESULTS: The probability of metastasis (%) was 2 for tumor staining of less than or equal to 10% and 93 for tumor staining >10% (P <0.0001). The tumor depth was less than or equal to 4 mm in 10 and >4 mm in 83 (P <0.0001). Patients with less than or equal to 4 mm and less than or equal to 10% staining had a 2% rate of recurrence, and patients,vith >4 mm and >10% staining had a 100% rate of recurrence (P <0.0001). CONCLUSION: Although tumor thickness Tvas suggestive of predictibility, only angiogenesis was a statistically significant predictor of recurrence in a multivariate analysis (P <0.0001). Angiogenesis showed a strong correlation with regional recurrence and may be used as an independent prognostic indicator.