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Increased microvascular density predicts relapse in Wilms' tumor.
Lisa P Abramson1, Paul E Grundy, Alfred W Rademaker
1Division of Pediatric Surgery, Children's Memorial Hospital, Department of Biostatistics, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Journal of Pediatric Surgery
|March 13, 2003
Summary
Increased microvascular density (MVD) in Wilms' tumors, particularly those with favorable histology, may predict relapse risk. This angiogenesis marker could help identify high-risk patients needing closer monitoring.
Area of Science:
- Oncology
- Pathology
- Angiogenesis Research
Background:
- Wilms' tumor prognosis typically relies on stage and histology.
- A subset of patients with favorable histology unexpectedly relapse.
- Increased microvascular density (MVD) is a marker of angiogenesis.
Purpose of the Study:
- To investigate if MVD can identify Wilms' tumor patients at risk for relapse.
- To assess MVD as a prognostic factor in Wilms' tumors, especially those with favorable histology.
Main Methods:
- A case-control study compared tumors from relapsed (n=15) and non-relapsed (n=35) patients.
- Tumor MVD was quantified using anti-Factor VIII antibody staining.
- MVD and clinical data were analyzed using univariate analysis and t-tests.
Main Results:
- Relapse group exhibited significantly higher MVD than the non-relapse group (34.9 vs 22.4 vessels/hpf).
- In favorable histology tumors, the relapse group also showed higher MVD (32.4 vs 19 vessels/hpf).
- MVD was the sole significant predictor of relapse among evaluated clinical factors.
Conclusions:
- Elevated MVD suggests a higher risk of relapse in Wilms' tumor patients.
- MVD may be particularly useful for identifying relapse risk in favorable histology cases.
- Further research with larger cohorts is recommended to validate MVD's role in patient stratification.