Intratumoral Microvessel Density in Advanced Epithelial Ovarian Cancer and its Use as a Prognostic Variable

Background: The aim of this retrospective study was to assess whether the intratumoral microvessel density (IMD) in primary tumour specimens had any impact on the clinical outcome of patients with advanced epithelial ovarian cancer treated in two Italian departments of gynaecological oncology. Materials and Methods: The study was conducted on 101 patients who underwent initial surgery followed by platinum-based chemotherapy (37) or paclitaxel/platinum-based chemotherapy (64) for International Federation of Gynecology and Obstetrics (FIGO) stage III-IV epithelial ovarian cancer. The median follow-up of survivors from initial surgery was 65 months (range, 27 to 132 months). Paraffin-embedded sections of primary tumour specimens were analysed for IMD by immunohistochemistry using anti-CD34 antibodies. Results: Progression-free survival and overall survival were significantly better in patients with IMD ≥40 microvessels/field compared with those with lower IMD (p=0.0105 and p=0.0065, respectively). Cox model showed that IMD was the strongest independent prognostic variable for both progression-free survival (p=0.0267) and overall survival (p=0.0189). Conclusion: An elevated IMD was associated with a significantly better progression-free survival and overall survival in patients with stage III-IV epithelial ovarian cancer who underwent initial surgery followed by chemotherapy, mainly consisting of a paclitaxel/platinum-based regimen.