Microvessel density at presentation predicts subsequent muscle invasion in superficial bladder cancer.

PURPOSE: The purpose of this study was to determine whether angiogenesis, as measured by microvessel density (MVD), at presentation is related to subsequent progression of superficial bladder cancer (SBC). EXPERIMENTAL DESIGN: Archived primary bladder tumors from 180 patients were stained with a monoclonal antibody against cluster determinant 34 to label vessels. Image analysis was used to count MVD in 30 randomly selected areas in each case. RESULTS: Of the 170 patients evaluated, 37 progressed to muscle invasive disease. A strong association was found between the intensity of angiogenesis and clinical stage, pT1 tumors having a higher MVD than pTa disease. The median MVD was significantly higher at presentation in those patients that subsequently developed progressive SBC than in those that did not progress (P < 0.0001). pT1 (P = 0.001), grade 3 disease (P = 0.002), and MVD (P = 0.008) were found to predict subsequent disease progression on univariable analysis. Both MVD (P = 0.007) and pT1 disease (P = 0.044) remained significant predictive factors for subsequent disease progression on multivariable analysis. CONCLUSION: MVD in SBC at presentation is significantly higher in those cases that subsequently progress to muscle invasive disease.