This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
High preoperative serum vascular endothelial growth factor levels predict poor clinical outcome after curative resection of gastric cancer. BJS 2009; 96: 1443-1451.
Published: 13th November 2009
Authors: Ó. Vidal, J.‐P. Metges, I. Elizalde, M. Valentíni, A. Volant, R. Molina et al.
Background
Tumour vascular endothelial growth factor (VEGF) and tumour urokinase‐type plasminogen activator (uPA) are prognostic factors in gastric cancer but surgical specimens are required for testing. The prognostic value of preoperative serum VEGF (s‐VEGF) and serum uPA (s‐uPA) levels was evaluated in patients undergoing potentially curative (R0) gastric cancer resection.
Method
Concentrations of s‐VEGF and s‐uPA were measured 97 patients with gastric cancer and 20 controls. Angiogenesis was measured in vitro based on human endothelial cell tube formation.
Results
Levels of s‐VEGF were higher in patients with gastric cancer than controls (median 288 versus 189 pg/ml respectively; P = 0·002). They were associated with pathological tumour node metastasis (pTNM) stage, pT, pN, lymph node ratio and perineural invasion, and correlated with platelet counts. In multivariable analysis, s‐VEGF over 320 pg/ml was the only preoperative predictor of both recurrence and disease‐specific survival. Serum from patients with raised s‐VEGF levels enhanced angiogenesis in vitro significantly more than serum from those with a s‐VEGF level of 320 pg/ml or less.
Conclusion
High preoperative s‐VEGF level is an independent prognostic factor for recurrence and survival after R0 resection of gastric cancer. This may provide a useful guide to decision making regarding neoadjuvant and adjuvant therapies. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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