Prognostic Significance of Tumor Volume and Microvessel Density in Squamous Cell Carcinoma of Uterine Cervix

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The purpose of the present study was to evaluate the prognostic significance and relationship between tumor volume and microvessel density in squamous cell carcinoma of the uterine cervix. The estimated tumor volume (TV) in 57 patients (22 stage Ib, 18 stage IIa, and 17 stage IIb) had radical hysterectomy was calculated on the assumption that the tumor mass was spheroid. The micro-vessel density (MVD) was evaluated as the ratio of endothelial area immunoreactive to factor-VIII related antigen (von Willebrand factor) to whole image area measured by computer-aided image analysis system. Tumor volume ranged from 0.1 to 41.0 cm3 (median 3.6 cm3) and MVD from 0.33 to 2.95 % (median 0.85 %). A significantly larger median TV was noted in women with positive pelvic node metastasis (6.3 vs 2.6 cm3, P=0.0228), parametrial invasion (8.9 vs 0.8 cm3, P< 0.0001), and postoperative irradiation (5.4 vs 0.6 cm3, P=0.0007). In contrast, these clinical parameters had no effect on MVD. There was no correlation between TV and MVD. The overall survival rate at 5 years was 93.1% and 60.7% (P=0.0037) between women with a TV of ≤4 cm3 and >4 cm3, respectively; and 96.2% and 61.3% (P=0.0022) between tissue specimens with a MVD of ≤0.8% and >0.8%, respectively. A combined TV of >4 cm3 and MVD >0.8% further deteriorated 5 year survival rate (42.1% vs 94.7%, P<0.0001). Multivariate analysis indicated TV and MVD as independent risk factor in this series (P=0.041, P=0.03, respectively). Our current findings suggested that TV and MVD are independent prognostic factors in women with cervical carcinoma who underwent radical hysterectomy. These prognostic factors may be clinically useful for the selection of high-risk patients who need extensive adjuvant therapy.

Prognostic Significance of Tumor Volume and Microvessel Density in Squamous Cell Carcinoma of Uterine Cervix

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