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Poor outcome in hypoxic endometrial carcinoma is related to vascular density

(2019) BRITISH JOURNAL OF CANCER. 120(11). p.1037-1044
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Abstract
BACKGROUND: Identification of endometrial carcinoma (EC) patients at high risk of recurrence is lacking. In this study, the prognostic role of hypoxia and angiogenesis was investigated in EC patients. METHODS: Tumour slides from EC patients were stained by immunofluorescence for carbonic anhydrase IX (CAIX) as hypoxic marker and CD34 for assessment of microvessel density (MVD). CAIX expression was determined in epithelial tumour cells, with a cut-off of 1%. MVD was assessed according to the Weidner method. Correlations with disease-specific survival (DSS), disease-free survival (DFS) and distant disease-free survival (DDFS) were calculated using Kaplan-Meier curves and Cox regression analysis. RESULTS: Sixty-three (16.4%) of 385 ECs showed positive CAIX expression with high vascular density. These ECs had a reduced DSS compared to tumours with either hypoxia or high vascular density (log-rank p = 0.002). Multivariable analysis showed that hypoxic tumours with high vascular density had a reduced DSS (hazard ratio [HR] 3.71, p = 0.002), DDFS (HR 2.68, p = 0.009) and a trend for reduced DFS (HR 1.87, p = 0.054). CONCLUSIONS: This study has shown that adverse outcome in hypoxic ECs is seen in the presence of high vascular density, suggesting an important role of angiogenesis in the metastatic process of hypoxic EC. Differential adjuvant treatment might be indicated for these patients.
Keywords
CARBONIC-ANHYDRASE-IX, LYMPH-NODE METASTASIS, PROGNOSTIC-SIGNIFICANCE, MICROVESSEL DENSITY, INDUCIBLE FACTOR-1, SPACE INVASION, BREAST-CANCER, TUMOR HYPOXIA, EXPRESSION, ANGIOGENESIS

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MLA
Reijnen, Casper, et al. “Poor Outcome in Hypoxic Endometrial Carcinoma Is Related to Vascular Density.” BRITISH JOURNAL OF CANCER, vol. 120, no. 11, 2019, pp. 1037–44.
APA
Reijnen, C., van Weelden, W. J., Arts, M. S., Peters, J. P., Rijken, P. F., Van de Vijver, K., … Pijnenborg, J. M. (2019). Poor outcome in hypoxic endometrial carcinoma is related to vascular density. BRITISH JOURNAL OF CANCER, 120(11), 1037–1044.
Chicago author-date
Reijnen, Casper, Willem Jan van Weelden, Martijn SJP Arts, Johan P Peters, Paul F Rijken, Koen Van de Vijver, Maria Santacana, et al. 2019. “Poor Outcome in Hypoxic Endometrial Carcinoma Is Related to Vascular Density.” BRITISH JOURNAL OF CANCER 120 (11): 1037–44.
Chicago author-date (all authors)
Reijnen, Casper, Willem Jan van Weelden, Martijn SJP Arts, Johan P Peters, Paul F Rijken, Koen Van de Vijver, Maria Santacana, Peter Bronsert, Johan Bulten, Marc Hirschfeld, Eva Colas, Antonio Gil-Moreno, Armando Reques, Gemma Mancebo, Camilla Krakstad, Jone Trovik, Ingfrid S Haldorsen, Jutta Huvila, Martin Koskas, Vit Weinberger, Lubos Minar, Eva Jandakova, Marc PLM Snijders, Saskia van den Berg-van Erp, Heidi VN Küsters-Vandevelde, Xavier Matias-Guiu, Frederic Amant, Leon FAG Massuger, Johan Bussink, and Johanna MA Pijnenborg. 2019. “Poor Outcome in Hypoxic Endometrial Carcinoma Is Related to Vascular Density.” BRITISH JOURNAL OF CANCER 120 (11): 1037–1044.
Vancouver
1.
Reijnen C, van Weelden WJ, Arts MS, Peters JP, Rijken PF, Van de Vijver K, et al. Poor outcome in hypoxic endometrial carcinoma is related to vascular density. BRITISH JOURNAL OF CANCER. 2019;120(11):1037–44.
IEEE
[1]
C. Reijnen et al., “Poor outcome in hypoxic endometrial carcinoma is related to vascular density,” BRITISH JOURNAL OF CANCER, vol. 120, no. 11, pp. 1037–1044, 2019.
@article{8614330,
  abstract     = {BACKGROUND: Identification of endometrial carcinoma (EC) patients at high risk of recurrence is lacking. In this study, the prognostic role of hypoxia and angiogenesis was investigated in EC patients.
METHODS: Tumour slides from EC patients were stained by immunofluorescence for carbonic anhydrase IX (CAIX) as hypoxic marker and CD34 for assessment of microvessel density (MVD). CAIX expression was determined in epithelial tumour cells, with a cut-off of 1%. MVD was assessed according to the Weidner method. Correlations with disease-specific survival (DSS), disease-free survival (DFS) and distant disease-free survival (DDFS) were calculated using Kaplan-Meier curves and Cox regression analysis.
RESULTS: Sixty-three (16.4%) of 385 ECs showed positive CAIX expression with high vascular density. These ECs had a reduced DSS compared to tumours with either hypoxia or high vascular density (log-rank p = 0.002). Multivariable analysis showed that hypoxic tumours with high vascular density had a reduced DSS (hazard ratio [HR] 3.71, p = 0.002), DDFS (HR 2.68, p = 0.009) and a trend for reduced DFS (HR 1.87, p = 0.054).
CONCLUSIONS: This study has shown that adverse outcome in hypoxic ECs is seen in the presence of high vascular density, suggesting an important role of angiogenesis in the metastatic process of hypoxic EC. Differential adjuvant treatment might be indicated for these patients.},
  author       = {Reijnen, Casper and van Weelden, Willem Jan and Arts, Martijn SJP and Peters, Johan P and Rijken, Paul F and Van de Vijver, Koen and Santacana, Maria and Bronsert, Peter and Bulten, Johan and Hirschfeld, Marc and Colas, Eva and Gil-Moreno, Antonio and Reques, Armando and Mancebo, Gemma and Krakstad, Camilla and Trovik, Jone and Haldorsen, Ingfrid S and Huvila, Jutta and Koskas, Martin and Weinberger, Vit and Minar, Lubos and Jandakova, Eva and Snijders, Marc PLM and van den Berg-van Erp, Saskia and Küsters-Vandevelde, Heidi VN and Matias-Guiu, Xavier and Amant, Frederic and Massuger, Leon FAG and Bussink, Johan and Pijnenborg, Johanna MA},
  issn         = {0007-0920},
  journal      = {BRITISH JOURNAL OF CANCER},
  keywords     = {CARBONIC-ANHYDRASE-IX,LYMPH-NODE METASTASIS,PROGNOSTIC-SIGNIFICANCE,MICROVESSEL DENSITY,INDUCIBLE FACTOR-1,SPACE INVASION,BREAST-CANCER,TUMOR HYPOXIA,EXPRESSION,ANGIOGENESIS},
  language     = {eng},
  number       = {11},
  pages        = {1037--1044},
  title        = {Poor outcome in hypoxic endometrial carcinoma is related to vascular density},
  url          = {http://dx.doi.org/10.1038/s41416-019-0461-2},
  volume       = {120},
  year         = {2019},
}

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