VESSEL COUNTS AND EXPRESSION OF VASCULAR ENDOTHELIAL GROWTH-FACTOR ASPROGNOSTIC FACTORS IN NODE-NEGATIVE COLON-CANCER

Background: The value of these prognostic factors was compared with th at of other clinicopathologic factors such as tumor grade, tumor stage , mucin production, vascular invasion, perineural invasion, and lympha tic invasion. Objective: To determine whether the development of dista nt recurrence in patients with node-negative colon cancer could be pre dicted using vessel count and vascular endothelial growth factor (VEGF ) expression. Design: Paraffin-embedded colon cancers were immunostain ed for factor VIII, VEGF, basic fibroblast growth factor, and prolifer ating cell nuclear antigen; slides were reviewed for differentiation, mucin production, and the presence of vascular, lymphatic, and/or peri neural invasion. Setting: A large academic cancer referral center wher e 27 patients with node-negative colon cancer were operated on during 1988 and 1989. Main Outcome Measure: The development of and interval t o recurrence. Results: Eight patients developed liver, lung, or lymph node metastases at a median of 24 months. The median follow-up for pat ients without cancer recurrence was 60 months. The mean tumor vessel c ount for those patients who remained disease-free was significantly fe wer than for those patients who suffered a recurrence (20 vs 33, respe ctively). By univariate analysis, 3 factors - perineural invasion, ves sel count, and VEGF expression - were correlated with time to recurren ce. BY multivariate analysis, only vessel count was significantly rela ted to differences in time to recurrence. Expression of VEGF correlate d with vessel count. Conclusion: Vessel count and expression of VEGF m ay be useful for predicting distant recurrence in patients with node-n egative colon cancer.