Lymphangiogenesis may portend head and neck cancer metastasis

Tumor lymphangiogenesis may indicate the risk of lymph node metastasis in patients with head and neck squamous cell carcinoma (HNSCC), according to a report in the September 1st issue of Cancer.

Recent evidence suggests that tumor-associated lymph vessels may be actively involved in the lymphatic spread of HNSCC, the authors explain, but it is unclear whether these vessels are associated with lymph node metastases or clinical outcomes.Dr. Alessandro Franchi and colleagues from University of Florence in Italy quantified lymphatic vessels within the tumor and in the peritumoral area in samples from 52 consecutive patients with HNSCC.Thin-walled lymphatic vessels were observed both within and around the tumor mass in all cases, the authors report.Peritumoral lymphatic vessels were larger, more numerous, and occupied a greater relative area than did intratumoral lymphatic vessels, the results indicate.Lymphatic vessel area and density were significantly higher in patients presenting with lymph node metastasis or with more advanced TNM stage tumors, the researchers note, but average vessel size did not differ between metastatic and nonmetastatic carcinomas.In a logistic regression analysis, high peritumoral lymphatic vessel density and area correlated significantly with a higher risk of lymph node metastasis. None of the other parameters, however, were significantly associated with lymph node metastasis.Higher lymphangiogenesis parameters tended to worsen overall survival and diminish disease-free intervals, the investigators report, but none of the associations reached statistical significance.”These results support the hypothesis that tumor-associated lymphangiogenesis is an active process that plays a clinically relevant role as the route for lymphatic dissemination in HNSCC,” the authors conclude.”This study, together with others, indicates that a certain modification of lymphatics may occur during tumor growth,” Dr. Franchi told Reuters Health. “This may help in the future to plan new therapeutic strategies.” “We are developing a method for evaluating the morphology of lymphatics in normal mucosa, dysplastic mucosa, and head and neck cancer using a 3-D reconstruction model,” Dr. Franchi added.(Source: Cancer 2004;10:973-978: Reuters Health: Will Boggs, MD: Oncolink: September 2004.)