Materials and Methods: The vascularity of primary untreated NB from 50 patients diagnosed at a single institution between 1984 and 1994 wets evaluated, An image processor was used to analyze the tumor tissue area for each histologic slide of tumor, and a vascular index (VI) was calculated, where VI = total number of vessels/mm(2) of tissue area, Tumors were classified histologically according to the criteria of Shimada et al (J Natl Cancer Inst 73:405-416, 1984), and N-myc copy number was determined by Southern blot analysis.

Results: We found that higher VI (> 4.0) in NE strongly correlated with widely disseminated disease (P = .006) and poor survival (P < .0001). VI more than 4.0 was also statistically associated with N-myc amplification (P = .02) and unfavorable histology (P = .02), Univariate analysis demonstrated that disease stage, tumor histology, and N-myc copy number were also predictive of outcome, Cox regression analysis showed that VI provided independent prognostic information.

Conclusion: Our studies indicate that angiogenesis may play an important role in determining the biologic behavior of NB. Antiangiogenic therapy may prove to be effective in the treatment of children with highly vascular, widely disseminated NB. (C) 1996 by American Society of Clinical Oncology.