Vascular endothelial growth factor: An important angiogenic mediator in bladder cancer

Angiogenesis is the growth of new blood vessels from existing ones and is c ritical for tumour development, invasion and metastasis. In bladder cancer the prognostic significance of mean vascular density, a surrogate for angio genesis, has lead to study of the factors determining the angiogenic phenot ype. The motivation for these studies has been the search for non-invasive prognostic or diagnostic markers for the disease and for new therapeutic st rategies against bladder cancer recurrence and progression. Whilst a large number of factors are involved in the mediation of tumour angiogenesis, vas cular endothelial growth factor (VEGF) is widely considered to be central t o the process. This review highlights the information presently available r egarding the role of VEGF in bladder cancer through observational studies o f its expression in bladder tumours and within the urine. In addition the v alue of VEGF in determining the prognosis in bladder cancer and the future possibilities for anti-VEGF therapy are discussed.