Tumor angiogenesis as a prognostic indicator in T2-T4 oral cavity squamous cell carcinoma: A clinical-pathologic correlation

Background. Tumor angiogenesis has been shown to correlate with tumor size, metastatic potential, and prognosis in breast and other cancers. Studies in head and neck cancer have suggested a similar correlation, but results have been inconclusive. This study was performed to determine the correlation between angiogenesis and oral tumor behavior. Methods. Tumor angiogenesis was evaluated in 31 T2-T4 primary oral cavity squamous cell carcinomas by quantitating the microvessel density with two different anti- endothelial cell antigens, factor VIII antigen (FVIIIAg) and CD-31. The stains were compared to assess whether these antigens yielded complimentary results. The microvessel densities were correlated with T stage and N stage and patient survival. Results. FVIIIAg and CD-31 staining yielded consistent microvessel densities, but FVIIIAg was generally more uniform and easier to interpret, increasing microvessel density was seen with increasing T stage and N stage; however, there was considerable overlap and no correlation with survival. Conclusions. These results suggest that oral tumors are less angiogenesis dependent than tumors in other sites. Tumor angiogenesis, as currently measured, is not of value in predicting tumor aggressiveness in patients with oral cavity carcinoma.