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Prospective study of prostate tumor angiogenesis and cancer-specific mortality in the health professionals follow-up study
Journal of Clinical Oncology, 11/03/09

Mucci LA et al. – Aggressive tumors form vessels that are primitive in morphology and function, with consequences for metastases. Vascular size and irregularity reflect the angiogenic potential of prostate cancer and may serve as biomarkers to predict prostate cancer mortality several years after diagnosis.

Methods

Evaluated microvessel morphology as predictor of prostate cancer mortality among 572 men in Health Professionals Follow-Up Study diagnosed with cancer during 1986 to 2000
Immunostained prostatectomy tumor block sections for endothelial marker CD34 and assessed microvessel density, vessel size (area and diameter), and irregularity of vessel lumen using image analysis
Proportional hazards models used to assess microvessel density and morphology in relation to lethal prostate cancer

Results

Poorly differentiated tumors exhibited greater microvessel density, greater irregularity of the vessel lumen, and smaller vessels
During 20 years of follow-up, 44 men developed bone metastases or died of cancer
Men with most irregularly shaped vessels were 17.1 times more likely (95% CI, 2.3 to 128) to develop lethal disease
Men with most irregularly shaped vessels were 17.1 times more likely (95% CI, 2.3 to 128) to develop lethal disease
Adjusting for Gleason grade and prostate-specific antigen levels did not qualitatively change results
Microvessel density not linked to cancer-specific mortality after adjusting for clinical factors

Exclusive Author Commentary
Lorelei Mucci, 11/03/09

Our data on vessel morphology and architecture further support the importance of angiogenesis in prostate cancer progression and the hypothesis that prostate cancer progression is marked by a rapid formation of neovasculature in tumors that are of smaller size and more poorly formed. The leaky and disordered function of these vessels has important implications for progression and prognosis.

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