P34 Angiogenesis at the primary tumor site is a potential driver of lymphatic metastasis in squamous cell carcinoma of the larynx

Abstract

Introduction Tumors with lymphatic metastasis require radical therapeutic management and have a poor prognosis. The mechanisms which drive metastasis to the lymph node in squamous cell carcinoma of the larynx are largely unknown. A pro-angiogenic tumor microenvironment may promote lymphatic metastasis. In this study we tested a possible correlation between markers of angiogenesis in the primary tumor and the degree of metastasis to the lymph nodes in a cohort of patients with laryngeal carcinoma. Methods The expression of CD31, VEGF and the number of CD31-positive vessels were analyzed by immunohistochemistry and scored in 83 patients with larynx carcinoma. Scores were correlated with N-stage, T-stage and overall survival. Results High VEGF expression correlated with high CD31 scores. High expression of both VEGF and CD31 correlated with high N-stage (N2 and N3). In patients with positive N status the subgroups of patients with high VEGF scores or a high number of CD31 positive vessels showed reduced overall survival. Conversely, patients with negative node status showed improved survival if VEGF score or the number of vessels were low. CD31 and VEGF scores did not correlate with T stage. Conclusion Our data suggest a possible link between high expression of pro-angiogenic markers in the primary tumor and lymphatic metastasis. Expression of VEGF and CD31 may predict poor prognosis in patients with positive lymph node status.