***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Potential predictive/prognostic angiogenic markers were prospect ively examined in a phase II trial of bevacizumab in epithelial ovarian cancer (EOC)/ primary peritoneal cancer ( PPC ) . METHODS Recurrent/persistent EOC/PPC patients were treated with bevacizumab ( 15 mg/kg IV q21days ) until disease progression . Vali date d-immunohistochemistry ( IHC ) assays were performed on pre-cycle 1/4 tumor biopsies for CD31-microvessel density ( MVD ) , VEGF-histoscore ( HS ) , p53-HS , and TSP1 image analysis score ( IA ) . Pre-cycle 1/4 serum and plasma VEGF were quantified using a vali date d-ELISA . RESULTS CD31-MVD and serum VEGF , evaluated pre-cycle 1 in 41/61 and 51/61 eligible patients , respectively , did not appear to be correlated . High CD31-MVD , categorized at the median , appeared to be associated with tumor response , a 13-month shorter median survival , and an increased risk of death ( unadjusted hazard ratio [ HR ] = 2.2 , 95 % confidence interval [ CI ] = 1.067 - 4.467 ) . In addition , each st and ard deviation ( SD ) increase in CD31-MVD appeared to be associated with worse survival in unadjusted and adjusted analyses . IHC and plasma biomarkers did not change with bevacizumab treatment except for serum VEGF , which appeared to decrease during bevacizumab treatment . This decrease was not associated with response . High pre-cycle 1 serum VEGF , categorized at the median , was associated with 22-month shorter median survival and an increased risk of death ( unadjusted HR = 2.7 , 95 % CI = 1.369 - 5.191 ) . Categorized p53 appeared to be associated with unadjusted survival and each SD increase in TSP1-IA appeared to be associated with a decreased risk of progression in unadjusted and adjusted analyses . CONCLUSIONS Despite the limitations in sample size and exploratory nature of the study , angiogenic markers in tumor and serum may provide prognostic value in recurrent/persistent EOC/PPC , and are being prospect ively evaluated in the GOG phase III trial of carboplatin , paclitaxel and bevacizumab/placebo in previously untreated EOC/PPC BACKGROUND Axillary lymph node status has been the most important prognostic factor in operable breast carcinoma , but it does not fully account for the varied disease outcome . More accurate prognostic indicators would help in selection of patients at high risk for disease recurrence and death who are c and i date s for systemic adjuvant therapy .  Our recent findings indicated that microvessel density ( count or grade ) in invasive breast carcinoma ( a measure of tumor angiogenesis ) is associated with metastasis and thus may be a prognostic indicator . PURPOSE This study was design ed to further define the relationship of microvessel density with overall and relapse-free survival and with other reported prognostic indicators in breast carcinoma . METHODS In a prospect i ve , blinded study of 165 consecutive patients , the microvessels within primary invasive breast carcinoma were highlighted by immunocytochemical staining to detect factor VIII-related antigen . Using light microscopy , we counted microvessels per 200x field in the most active areas of neovascularization and grade d microvessel density . These findings were correlated , by univariate and multivariate analyses , with overall and relapse-free survival , axillary node status , and other prognostic indicators ( median follow-up , 51 months ) . RESULTS There was a highly significant ( P < or = .001 ) association of microvessel density with overall survival and relapse-free survival in all patients , including node-negative and node-positive subsets . All patients with breast carcinomas having more than 100 microvessels per 200x field experienced tumor recurrence within 33 months of diagnosis , compared with less than 5 % of the patients with breast carcinoma having 33 or fewer microvessels per 200x field . Moreover , microvessel density was the only statistically significant predictor of overall survival among node-negative women ( P < .001 ) . Only microvessel density ( P < .001 ) and histologic grade ( P = .04 ) showed statistically significant correlations with relapse-free survival in the node-negative subset . CONCLUSIONS Microvessel density in the area of the most intense neovascularization in invasive breast carcinoma is an independent and highly significant prognostic indicator for overall and relapse-free survival in patients with early-stage breast carcinoma ( I or II by International Union Against Cancer criteria ) . IMPLICATION S Such an indicator would be useful in selection of those node-negative patients with breast carcinoma who are at high risk for having occult metastasis at presentation . These patients could then be given systemic adjuvant therapy BACKGROUND Some r and omised controlled trials ( RCTs ) done in German-speaking Europe are published in international English- language journals and others in national German- language journals . We assessed whether authors are more likely to report trials with statistically significant results in English than in German . METHODS We studied pairs of RCT reports , matched for first author and time of publication , with one report published in German and the other in English . Pairs were identified from reports round in a manual search of five leading German- language journals and from reports published by the same authors in English found on Medline .  Quality of methods and reporting were assessed with two different scales by two investigators who were unaware of authors ' identities , affiliations , and other characteristics of trial reports . Main study endpoints were selected by two investigators who were unaware of trial results . Our main outcome was the number of pairs of studies in which the levels of significance ( shown by p values ) were discordant . FINDINGS 62 eligible pairs of reports were identified but 19 ( 31 % ) were excluded because they were duplicate publications . A further three pairs ( 5 % ) were excluded because no p values were given . The remaining 40 pairs were analysed . Design characteristics and quality features were similar for reports in both language s. Only 35 % of German- language articles , compared with 62 % of English- language articles , reported significant ( p < 0.05 ) differences in the main endpoint between study and control groups ( p = 0.002 by McNemar 's test ) . Logistic regression showed that the only characteristic that predicted publication in an English- language journal was a significant result . The odds ratio for publication of trials with significant results in English was 3.75 ( 95 % CI 1.25 - 11.3 ) . INTERPRETATION Authors were more likely to publish RCTs in an English- language journal if the results were statistically significant . English language bias may , therefore , be introduced in review s and meta-analyses if they include only trials reported in English . The effort of the Cochrane Collaboration to identify as many controlled trials as possible , through the manual search of many medical journals published in different language s will help to reduce such bias Hazard ratios ( HRs ) are used commonly to report results from r and omized clinical trials in oncology . However , they remain one of the most perplexing concepts for clinicians . A good underst and ing of HRs is needed to effectively interpret the medical literature to make important treatment decisions . This article provides clear guidelines to clinicians about how to appropriately interpret HRs . While this article focuses on the commonly used methods , the authors acknowledge that other statistical methods exist for analyzing survival data OBJECTIVES The aims of this study were to examine prognostic significance of  microvessel density ( MVD )  in previously-untreated , advanced epithelial ovarian cancer ( EOC ) and explore associations between MVD and factors that affect angiogenesis . METHODS  MVD  was determined by immunohistochemical expression of CD31 or CD105 in tumor sections from 106 women treated on GOG r and omized phase III trials .  Average MVD hotspots were quantified by light microscopy at high power ( x400 ) and categorized as low ( or = upper quartile ) . Immunoblot expression of MASPIN , THBS-1 , bFGF , VEGF , VEGFR-1 and p53 status ( mutation and overexpression ) was previously determined . RESULTS Of 106 evaluable cases , 25 % exhibited high  CD31-MVD  ( > 24.25 vessels/high power field [ HPF ] ) or high  CD105-MVD  ( > 19.25 vessels/HPF ) . After adjusting for age and stratifying by GOG performance status , stage , cell type , grade , debulking status and treatment regimen , high versus low CD105-MVD was associated with increased risk of disease progression ( hazard ratio [HR]=1.873 ; 95 % confidence interval [ CI ] : 1.102 - 3.184 ; p=0.020 ) , but not death ( HR=1.125 ; 95 % CI : 0.654 - 1.935 ; p=0.670 ) whereas CD31-MVD was not associated with risk of disease progression ( HR=1.578 ; 95 % CI=0.918 - 2.711 ; p=0.099 ) or death ( HR=1.678 ; 95 % CI=0.957 - 2.943 ; p=0.071 ) . CD31-MVD was correlated with CD105-MVD ( p=0.001 ) and MASPIN ( p=0.016 ) . Neither CD31-MVD nor CD105-MVD was associated with p53 status , THBS-1 , bFGF , VEGF or VEGFR-1 . CONCLUSIONS High MVD assessed using CD105 , a marker of proliferating endothelial cells and neoangiogenesis , but not CD31 a pan-endothelial marker , appeared to be an independent prognostic factor for worse progression-free survival in women with advanced EOC after adjusting for prognostic clinical covariates 
    Output:
    
The OS and PFS with high MVD were significant poorer than with low MVD in ovarian cancer patients .
However , high MVD detected by CD34 seems to be more associated with survival for patients without pre-chemotherapy