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Serum VEGF and VEGF-C values before surgery and after postoperative treatment in gastric cancer

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Abstract

Introduction

Angiogenesis and lymphangiogenesis are essential processes for the formation of blood and lymphatic vessels that allow tumour growth and spread. The binding of VEGF and VEGF-C factors with their receptors (VEGFR2, VEGFR3) in endothelial cells triggers signals that regulate these processes. We compared preoperative serum VEGF and VEGF-C levels with samples obtained after completion of surgery and adjuvant treatment in patients with gastric cancer. In addition, we determined the prognostic value and relationship to survival of serum VEGF and VEGF-C levels.

Methods

We used a prospective cohort study of 59 gastric cancer patients who underwent surgery. Serum VEGF and VEGF-C were measured by enzyme-linked immunosorbent assay (ELISA) the day before surgery and 6 months later, after completion of adjuvant treatment.

Results

Serum VEGF values decreased after treatment in patients with resectable tumours (mean ± SD) (405.42 ± 298.38 vs. 306.38 ± 212.47 pg/ml; p < 0.01), poorly differentiated and undifferentiated tumours (G3, G4) (438 ± 339.71 vs. 322.47 ± 210.71 pg/ml; p = 0.01), locally advanced gastric tumours (T4 stage) (424.27 ± 323.08 vs. 333.62 ± 221.72 pg/ml; p = 0.03) and tumours with a greater number of involved regional lymph nodes (N3) (442.38 ± 311.52 vs. 337.4 ± 203.64 pg/ml; p = 0.04). Serum preoperative VEGF values over 761 pg/ml were associated with shorter patient survival. The mean overall survival time for patients with serum VEGF levels higher than 761 pg/ml was 7 ± 2.99 months (95 % CI 1.14–12.86) while for patients with serum VEGF levels of less than 761 pg/ml was 21.18 ± 2.88 (95 % CI 15.54–26.83) The mean disease-specific survival time for patients with serum VEGF levels higher than 761 pg/ml was 6.25 ± 2.53 months (95 % CI 1.29–11.21) while for patients with serum VEGF levels of less than 761 pg/ml was 27.57 ± 3.45 (95 % CI 20.80–34.35). Multivariate analysis identified preoperative serum VEGF levels as an independent prognostic factor (HR = 0.144; p = 0.03).

Conclusions

Serum VEGF levels decreased after the completion of treatment in patients with resected tumours, suggesting VEGF tracking may be useful in monitoring progression. Preoperative measurement of serum VEGF may help us identify patients with a poor prognosis.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Hospital Universitario de Ciudad Real, Carretera Piedrabuena, 20/26-A, Ciudad Real, 13005, Spain

    Pedro Villarejo-Campos, David Padilla-Valverde, Pablo Menéndez-Sánchez, Teófilo Cubo-Cintas & Jesús Martín Fernández

  2. Área de Estadística e Innovación Operativa. Departamento de Matemáticas, Universidad de Castilla-La Mancha, Castilla La Mancha, Spain

    Raúl Martin Martin

  3. Facultad de Medicina, Universidad de Málaga, Málaga, Spain

    Jose Antonio Bondia-Navarro

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  1. Pedro Villarejo-Campos
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Correspondence to Pedro Villarejo-Campos.

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Villarejo-Campos, P., Padilla-Valverde, D., Martin, R.M. et al. Serum VEGF and VEGF-C values before surgery and after postoperative treatment in gastric cancer. Clin Transl Oncol 15, 265–270 (2013). https://doi.org/10.1007/s12094-012-0908-x

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  • DOI: https://doi.org/10.1007/s12094-012-0908-x

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