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dc.contributor.authorReijnen, Casperen_US
dc.contributor.authorvan Weelden, Willem Janen_US
dc.contributor.authorArts, Martijn S.J.P.en_US
dc.contributor.authorPeters, Johan P.en_US
dc.contributor.authorRijken, Paul F.en_US
dc.contributor.authorvan de Vijver, Koenen_US
dc.contributor.authorSantacana, Mariaen_US
dc.contributor.authorBronsert, Peteren_US
dc.contributor.authorBulten, Johanen_US
dc.contributor.authorHirschfeld, Marcen_US
dc.contributor.authorColas, Evaen_US
dc.contributor.authorGil-Moreno, Antonioen_US
dc.contributor.authorReques, Armandoen_US
dc.contributor.authorMancebo, Gemmaen_US
dc.contributor.authorKrakstad, Camillaen_US
dc.contributor.authorTrovik, Joneen_US
dc.contributor.authorHaldorsen, Ingfrid S.en_US
dc.contributor.authorHuvila, Juttaen_US
dc.contributor.authorKoskas, Martinen_US
dc.contributor.authorWeinberger, Viten_US
dc.contributor.authorMinar, Lubosen_US
dc.contributor.authorJandakova, Evaen_US
dc.contributor.authorSnijders, Marc P.L.M.en_US
dc.contributor.authorvan den Berg-van Erp, Saskiaen_US
dc.contributor.authorKüsters-Vandevelde, Heidi V.N.en_US
dc.contributor.authorMatias-Guiu, Xavieren_US
dc.contributor.authorAmant, Fredericen_US
dc.contributor.authorMassuger, Leon F.A.G.en_US
dc.contributor.authorBussink, Johanen_US
dc.contributor.authorPijnenborg, Johanna M.A.en_US
dc.PublishedReijnen, van Weelden, Arts, Peters, Rijken, van de Vijver, Santacana M, Bronsert P, Bulten J, Hirschfeld M, Colas E, Gil-Moreno A, Reques, Mancebo G, Krakstad C, Trovik J, Haldorsen IS, Huvila J, Koskas M, Weinberger V, Minar L, Jandakova E, Snijders MP, van den Berg-van Erp S, Küsters-Vandevelde, Matias-Guiu X, Amant F, Massuger LF, Bussink J, Pijnenborg JM. Poor outcome in hypoxic endometrial carcinoma is related to vascular density. British Journal of Cancer. 2019;120(11):1037-1044eng
dc.description.abstractBackground 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.en_US
dc.publisherSpringer Natureeng
dc.rightsAttribution CC BYeng
dc.titlePoor outcome in hypoxic endometrial carcinoma is related to vascular densityen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright Cancer Research UK 2019
dc.source.journalBritish Journal of Cancer
dc.relation.projectKreftforeningen: 190202
dc.relation.projectNorges forskningsråd: 273280

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